HomeMy WebLinkAboutrequest for 30 day for power form 07-20-'21 09:20 FROM- 7728787656 T-242 P0001/0001 F-924
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772-462-21 5 Fax 772-462-6443
Request for 30-Day-Tempomry Power-Release
Permit Number
Project Address; � � `�• �� �� ���.
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO'EXCEEDTHIRIY(30)•DAYS; FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARAITO.N FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST VIA HBZE Y ACKNOWLEDGE AND AGREE AS FOLLOWS:
I., This temporary power release is eeguested for the above stated purpose only,and 01ere will be no
occupancy of any type, other than that permitted by eohstmcdon during this time period.
2. As W&vess by our signature ,we hereby agree to abide by d terms and conditions of this agreement,
Including Bonding Division Policy,which is incorporated herein by reference.
3. All conditions and requirements listed in the aattadied document entitled"Requirements for 30 Day
Power for 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 siatlng
the reasori for the request Power may be removed'from.the site and/or a Stop Work Order issued if
the Finai•Inspecl3on 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
DISCONNEcrim OF ELECTRICAL POWER IN THE S&VT OF VIOLATION OF PHIS AGREEMENT.
I
OWNER SIGNATURE DA
GE CO DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE