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HomeMy WebLinkAboutRequest for 30 day for power Release Form 08-11-'21 11 :07 FROM- 7728787656 T-358 P0002/0002 F-034 Pt�naing-&-be 1e�t�ent�r�ces Bu ldh o--a r is:R�eg�r I iar�.-Divi$ian -23.0�r,f a Ave- . . .. .�.- Fort-Kern FL 4 82 3� 772,"Z—' 165 Fax 772=462-6443 Request-for 30-Day Temporary. Power:Release Date: `\�c L Permit �UZ>:6. Prqed Address: I, THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL.POWER 70 THE ABOVE DESGUBED PROPERTY, FOR A PERIOD NOT TO EXCEE3THIRTY.(30)DAYS, FOR THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FORA FINAL INSPECRON. IN CONMERATION OF APPROVAL OF THE REQUEST WE mEREBY ACKN©w EDGE AND AGUE A5 FOLLOWS: 1. This temporary power r0ew is requested for the above SWW PxPose cdy,and tee wlil be no occupancy of any type,;other than that permitted.by construction during'thrs time period. 2. As witness try our signatures,we hereby agree to abide by all terms and conditions of this agreement, including Building Division Policy,which is incorporated herein by reference. 3. All condin'ons:and motg 2ments Ilsted in the atta'ehvi document entfflbd-Requirements for 30 Day Power for T.esdng"have been'fUffiled and the'premise is ready for coinpliante inspection. 4. All requests fvr an,extension beyond 30 days must be made in vvrit it g to the Building Offidat stating the reason'for the request Power may be removed`from,the,site and/or a Stop Work Order issues if Me Final'Inspedidn has not been approved vvrthin 30 days, A fee of$100.00 will be required to lift the Stop Worts Order. WE HEREBY RELEASE AND AGREE To.HOLD.WARMLESS,-ST.,LUCIE COUNTY,AND THEIR EMPLOYEES FROM ALL LIABHXMS AND.CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT OF THiS TRANSACTION;INCLUDING ANY DAMAGEVTUI H`MMAY BE INCUk2RED DUE TO THE DI.SCONNECI30N OF ELECTRICAL POWER IN THE-EVENT OF WOLA110N OF THIS A,GREEWW. OWNER E ; DATE ' +CONTRACMR. DAUP TE ELECTRICAL CONTRACTOR SIGNATURE DATE KELLIVItU E - EtID ACLPermitSt. L