HomeMy WebLinkAbout30- day request for temp power form07-14--'21 15:36 FROM-
7728787656 T-232 P0005/0005 F-910
"h4*6iev oment'Seerices
BuMn.g°& 146A gol,tinrr Division
23011ji a AVe•
Ford' Piet; FLi ;
772-�462-2-1-W Fax '772Li "2-6443
Regoest'for '30-B.ay' Tet 6�arq ' Powb :Release
Dade:
Piet Address:
Permit dumber: 12•
THE UNDERSIGNED HEREBY REQUEST -RELEASE OF ELECTRM, CAL. POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY(n) •OQYS, FOR THE PURPosE OF TESTING SYSTEMS
AND EQUIPMENT IN 'PREPARATION FORA FINAL MSPECTION. IN, CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AGREE AS FOLLO3'lliS-
2. Thls tEmpararypower release is requested for the move sUited purpose only, aid there wry be no
occupancy of any type, 9brx than that permitted by.cWstruction during this time period.,
2. As -witness by our signatures, we hereby. Vee to abide by all terms Arid -conditions of this agreement,
including Building Division Valicy, which is lrxor crated Wr6n by refeOnce.
3. All conditi'ons'and requkahents. lisked,ur the attached doaffneM entit3ed "Requirements for 30 Day
Power for Testing" have been tuffs led and the premise is ready for compliance inspection.
4. All requests for an ex6erdon beyond 30 days must be'made in writ to ttae Building Official stating
the reasonfor the requdst. Power may be rejhoved••frotn 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 tfft
the Stop Work' Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARwEss, ST. LUCiE OOuNTY, AND THEIR EMPLOYEES FROM
ALL LTABI=S AND CLAIMS OF MY TYPE- OF NATURE WHICH f4AY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION; INCLUDING ANYIYAMAGBwai MAY BE INCURM DUE TO THE
DISCONMMON OF ELEC f U0%L Pt' wER IN THE EvENt OF VI0I.A -m 6F itus AG3EEmENT.
AtefA1GD CT%`tU•Ae.uf _ _
DATE