HomeMy WebLinkAbout30 dayPlanning & Development Services
Building &IICode Requlation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Terr'porary PoWer Release
Date:S- aC�a�
- Permit Number;
Project Address:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWERc
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING
A!VD EQUIPMENT IN PREPARATION FOR A FINAL INSPECTI TO THE ABOVE pESC�gFEj
REQUEST WE HER~BY ACKNOWLEDGE AND AGREE INSPECTION. IN CONSIDERATION OF APPROVAL
FREE AS FOLLOWS; THE
! . This tem ra: y a
a Power release is requested for the above stated purpose orliy, and then_ will no
occupancy of any type, other than that permitted by construction Burin this timeperiod.
=- As witness by our signatures, we hereby a;ree to abide by all terms and conditions of this ^re
includin Building pi 9 g Division Policy, which is incorporated herein by reference. zment,
3. 41! conditions and requirements listed in the attached docurnent entitled "Requirement for 30 �-
Power For Testing'' have been fulfilled and ►the premise is ready for compliance inspection.
All requests for an eytension beyond 30 day, must be made in rniting to the Building` i,
the reason for the request. Power may be removed from the site andlor a St ,
the Final Inspection has not been approved within 30 da s. Official sia,in�
the Stop *ark Order.
y A fee of 100.00 will be r2�di �,ru'` it
q� tc i;Y
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY AND
o
_L LIA81L]TIES AND CLAIMS OF ANY TYPE
OF THIS TRGNSA OF NATURE WHICH MAY' ARISE NOW OR IN THE F�►T 1Et tnC)rt
ALLCTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT `R` 4.ET
� GATE
GENE-77
P,Al CGtJTRAC7JN. SIGNATURE •---- � � -2.6
ELECTRICAL CONTRACTOR SISNATIJRE�