HomeMy WebLinkAboutpower releasePlanning & Development Services
ISTLUCIT Building Bit ode Regulation Division
2300 Virgitlia Ave
• Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date, " 10-- a0311
_5
Permit Number: _ _ ;1) 0 a - O l 71
S •S S
Pr ojlect Address: .(J
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE Oc""SCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTE.M5
AND EQJIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUES'r WE HERE -BY ACKNOWLEDGE AND AGREE AS FOLLOWS:
This tempo raj,' power release is requested for the above stated purpose only, and there viiii be no
occupancy of any type, other than that permitted by construction during this time period
As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
mouoing Building Division Policy, which is incorporated herein by reference.
3 41cor.dit-ors and requirements listed in the attached document entitled "Requirements f�y .30 Diet'
Power for Testing" have been fulfilled and the piemise is ready for compliance inspection.
r Ali 'equests for an extension beyond 30 days must be made in Writing to the Budding Official statir±g
tee reason for the reauest. Power may be removed from the site and/or a Stop Work Order,ssued it
the Final Inspection has not been approved within 30 days. A fee of g 100.0t) will be requirel tG t!ft
,.,E Stop V►ark Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
Awe LIAEIJTIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
O;: THIS TRA%I SACTICN, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCJtvNEC CIO;, OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGgEE,%IEIC
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Nlr_'JlwSIGNATUR.E DATE — !
48 - 10
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