HomeMy WebLinkAboutpower releaseYlanningatrd lleveiopmertt Semees
Building and Code Regulations
2300 Virginia Avenue
Fort Pierce, FL 34983
772462-1553
Fax 772462-6443
rlEMPORARv EARLY POWER RELEASE
(Name of Tenant or Owner)
The "Tenant or Owner requests St Lucie County Developmeta Services Department to release the
electrical power at�����' A�►9f
(address, including suite number,
as posted on the electric meter and the building) for building permit # 210 �-G ,for the
Purpose of construction and testing building systems, including air conditioning, refrigeration,
lighting, power and control circuits with the following stipulations:
1. Incomplete ar untested circuits axe NOT to be energized without properly licensed electrical
Personnel on the jobsite and no systems are to retrain energized beyond the testing/temporary
Purpose without proper inspection by the St Lucie County Building Department appropriately
licensed personts).
2. All panels and disconnects not in use must be locked in the "OFF" position or fuses removed.
3. Proper procedures for ]vckoudtagout must be in place.
4. The electrical equipment room (where applicable) will remain locked at all times with tine key in
the possession of the electrical contractor.
5. All final inspections relative to the closeout of this project must be requested and passed in a
timely manner as determined by the Electrical Inspector and/or the Building Official.
b• The butluuig many not be occupied before a Certificate of Occupancy (C.o.) is issued.
7. No stacking afmaterials, other than those required for construction is permitted by this agreement
8. No on -site occupancy or training of personnel employed by [lie occupant, business entity or o
is permitted by this agreement wner
9. No furniture, racks, furnishings or other personal or corporate property is permitted on site by this
agreement.
10. conch etien pewer mmaainc cevrred T-Y L"e rn��ymW �� fur C-IPCT nm},�r�nn ���11 nthvr
requirements of the governing Codes, see National Electrical Code (NEC) Article 590. d
Violation of this agreement may result in the immediate termination of the electrical power without
prior notice or warning to the affected parties. This form requires all of the following signatures
pnur iu power bring rcieaseti. Tiic undersigned acknowietigc %ira€ ill uperaeiurr ui air currurlivnirrg
equipment while construction is in progress may create or increase the risk of contamination or
Premature failure of the equipment.
The undersigned acknowledges the above listed stipulations, agrees to the terms of this agreement
and agrees to hold St Lucie County harmless from any damaees that may arise as a result of the
release of power to the premises. The undersigned hereby requests power to be released for this
project. This form does not guarantee power, which is at the discretion and control of the electrical
utility.
1
9 .
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Important: The occupant of the property (or other appropriate party) shall have made proper
application to the electric utility, paid any applicable fees or deposits, and requested power in a
timely and informed manner. St Lucie County is not responsible for any delays in the receipt of
electric power.
`; 7, �rlr rnfrla a 'q 8p.",., t1,P t ?m?.c of tlyyc nEmli etnti `hla fiLrfle`r a1rnnzylPr3isP that cn�l�fi�u
of this agreement or a finding of unsafe conditions and/or practices found on the site or ocupancy
Of the site may result in immediate disconnection of this temporary power without wc
arning and
hereby release St Lucie County and all representatives of any and all liability resulting from us not
abiding with this agreement.
Print Name - Electrical Contractor Coinparay Name
Signatu - Electri Contractor Date
/ ��Ixw
Print ivatne - Eiectricai Conu "lor
Phone Number - Electrical Contractor
70
i irrrecr� # 1F�rr _'raf i-'nnfrartnr
Signatuue - rune Contractor Date
Print Name - Prime Ca actor
eL-e/s/X.57%a
License # Prime Contractor
Approved for St. Lucie County by:
Signature - Electrical Inspector/gQ Insp ID #
inspector coinments, limitations and restrictions:
4inature - ner
Date
mint Name - Owner
Phone Number - Owner
Print Name - Prime Contractor Comp Name
Phone Number - Prime Contractor
Date
2