HomeMy WebLinkAbout30 day power release_ Planning & Development Services
_ Building & ICode Regulation Division
• 2300 Virginia Ave
• Fort Pierce, FL 34992
772-462-2165 Fax 772-462-6443
Request for 30-Day "temporary Power Release
Date: I ` ��� 1�
RermEL Number;
Project Address: J Ll
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 THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS'
! This temporary power release is requested for the above stated Purpose ooiy, and there will be no
occupancy of any type, other than that permitted by construction during this time period.
2. As witness by our signatures, we hereby az _e to abide by all term=, and conditions of this agreement,
including Building Division Policy, which is incorporated herein br reference.
3 All conditions and requirements listed in the attached document entitled "Requirements for 30 17ay
Power for Testing" have bern fulfilled and the premise is ready for compliance inspection.
q. All requests for an extension beyond 30 days must be made in rmting to the Building Official stating
the reason for the request. Power may he removed from the site and .!o; a Strop Work Order issued! if
the Final Inspection has not been approved w�thin 30 days. A fee of $100 a) will be required tc 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 THE FUTURE 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
IGNATUR:
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9-8z 1
DATE
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GENERAL COWPACTrOR SIGNATURE DATE
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ELECTRICAL CONTRACTOR SIGNATURE DATE