HomeMy WebLinkAboutPower Release form Planning & Development Services
8uilciing & Code - Reg ulatlon Division
2.,00 Virginia Ave
k Fort Pierce, FL 34982
Y :�_ __ i 47 72w4G2 - 2165 Pax T72-462m 4 3
Request for 30 � Day Temporary Power Release
Date ; 4/ 16/2021 Permit Number : C;Z l ox - 00 3
Project Address ; Lot 18 5154 Armina Place
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 Ti-lE
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, lotherthan that permitted by construction during this time period .
2 . As , witrness try our signatures, we herby agree to abide by all terms and conditions of this agreement;
Including Building Division Policy, which is Incorporated herein by -reference .
3 : All conditions and requirements listed In the attached document entitled " Requirements for 30 Day
Power for Testing "' have been fulfilled and -the premise Is ready- for compliance inspection .
4s 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 OrderIssued 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 THETUTURE 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,
I4covai B4rkwhagen 4/ 16/2021
OWN R Site - ATURE DATE
Joseph .spalt4 4/ 16/2021
GENERAL CONTRACTO SIGNATURE DATE
4/ 16/2021
ELECT . ICAL CONTRACTOR iSIGNATURE DATE