HomeMy WebLinkAbout20210907141402439Virg, oil Iin fib'? 114el9e0PnAlle01v,(i
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�1_-C:�, !► " a . _� = -- Fort Fierce, FL MRS982
Date: 09/03/2021
Pro��Ck Address: lot 20, 5146 Arming Place
2102-0587
Permit Number.
-THE UNDERSZGIVED HERESYREQUEST RELEASE aF ELECTRICAL P01111ER TQ THEE 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
EQUESTT WE :HEREBY ACKNOWLEDGE AND -AGREE AS FOLLOWS,
1: This temporory power release is requested for the above stated purpose only; and there will. beano
occupancy. of ahy type,sother'than that permitted by.construction during this time period.
2. As,witness key our signatures, we herby agree to abide by all terins and conditions of this agreement-
4 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 beers fuifllled and=the premise Is -ready for compilance inspection.
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 Stopm Work Ordervissued i1. f
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. Ll1CIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES -AND CLAIMS (a.F ANY TYPE OF NATURE WHICH. MAY ARYSE ND_IN OR �N THE.FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY gE INCUARED DUE T06THE.
DISCONNECTION OF ELECTRICAL.P.OWER. IN THE EVENT OF VIOLATION OF THIS *AGREEMENT,
OWNER
GENE
PATE
Joseph 5palt 6/7/2021
RACTOR fSIGNATUREAffDATE
ELECTi�ICAL CONTRACTOR;STGNATURE
6/7/2021
DATE