HomeMy WebLinkAboutTemporary Power Release t�
RECEIVED
JUN 17 2021
St.Lucie County
Permitting
Building (ode ReomiattiOn DMDEROR
2300 W90floo&usr
fort Foeme, FL 34982
Request for so-Dail/Temp aimov Power Mane
Date: ���� Z Z% Permit Number: — 61/-7
Project Address: %�—i�✓� U/u�-��
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FOR A PERIOD NOT TO EXCEED THIRTY(30)DAYS,FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose only,and there will be no
occupancy of any type,other than that permitted by construction during this time period.
2. As witness by our signatures,we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policyi which is incorporated herein by reference.
3. All conditions and requirements listed In the attached document entitled"Requirements far 30 Day
Power far Testing"have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order Issued if
the Final Inspection has not been approved within 30 days. A fee of$100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST.LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION,INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
MA&L -'� (� hlvr' i 7`2 v2/
O ER SIGN RE Ca"A !!1� DATE
09- ( /7 a0-Z
GEN RAL copiTRACroR GNATURE DATE
Jp .� ;)�,�=� �• Goldstar Electric, Inc. �Zo z j
ELECTRICAL CONTRACTOR SIGNATURE DATE