HomeMy WebLinkAboutPace Temp Power 11097 S Indian River Dr.pdfPlanning & Development Services
Q8u~lding & Code Regulation Division
2300 Virginia Ave
Font Pierce, FL 34982
Request for 30-Day Temporary Power Release
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Date:ote�Permit Number,
Project Address-, ! \��r�-7
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIR TY (3W DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT I0PHEPARATIDNFOR AFINAL INSPECTION. INCONSIDERATION UFAPPROVAL UFTHE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS,,
z. This temporary power release is requested for the above stated purpose only, and there will be no
occupancy or any type, other than that permitted by construction during this time period,
_^ _~_. witness ~~, Our signatures, == hereby agree mabide ovall terms and conditions orthis agreement,
including Building Division PWicy, which |sincorporated herein �yreference,
aAll conditions and requirements listed in the attached document entitled "Requirements for 30 Day
Power for Testing" have been fu|h||eU and the premise is ready for compliance inspection,
«. All requests for ao extension bevunN3O gays must be made in writing to the Building Official stating
the reason for the request. Power may removed from the site and/or aStop Work Order is5ued if
the Final Inspection has not been approved within 30days, Afee of $100.00 will be required to lift,
the stop Work Order,
tNEHEREBY RELEASE AND AGREE TDHOLD HARMLESS, ST,LUCIECOUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OFTHIS TKANSA[TION,INCLUDING ANY DAMAGE WHICH MAY BEINCURRED DUE TOTHE
DISCONNECTION OFELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE DATE
GENERAL