HomeMy WebLinkAbout30 day19- WWI Planning & Development Services
_ Building & Icode Regulation Division
• 2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Date,
Request for 30-Daly Temporary Power Release
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Project Address
Permit Number; _ 0 1 1__0 616
3 y 4- Lv_a o S d
THE LINDERSIGNED 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: THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose oniy, and there 4Yiil 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,including Building Division Policy, which is inr_orporated herein br reference.
s. All conditions and requirements listed in the attached doc:urnent entit!ed "Requirement, for 30) Day
Power `or Testing" have been fulfilled and the premise is ready for compliance inspection.
q Ali requests for an extension beyond 30 day; must be made in 'rfiiting to the Bwlding Official statin3 tF,e reason for the reqif
uest. Power may be removed frorn the site andlor a Stop Work Order issu_c the Final Inspection has not been approved within 30 days. A fee of'$100.00 will to required tc !;;*
the Stop ltiark Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
Al LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUT,IRE OJT
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
QZ'INEP SIGNATURE
GENERAL COhITPACTOk SIGNATURE
ELECTRICAL CONTRACTOk 51SNATURE
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DATE
DATE
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