HomeMy WebLinkAboutOffice Request for 30-Day Temp Power 09-212 21 13:07 FROM- 7728787656 T-537 P0001/0001 F-242
Plallxneda.&.0 ment setivices
'Buififing &Codie Nebula do Division
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Folly I�iee�Ce; FI 98�
772-402=216S" Fax 772-"2-6443
Reguest'for 30-Day Temporary'.Power Release
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Date, ���r�u�rer: s—z-)
P vjW Address: � Q.C\ tQ
THE UNDERSIGNED HEREBY REQUEST_aELE*OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FOR A PERIOD NOT TO EXCEED-THMTY(30)-DAYS,FOR THE PURPOSE OF*TESTING SYSTEMS
AND EQUIPMENT INPREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE-HEREEX ACI NOW4.EDGE AND AGREE AS FOLLOWS:
1. This temporary-power release is requested for the above shed purpm only,and there wfil be no
occupancy of any type,.other than that permitted by aorsvcdon during,this time period.
2. As witness by.our signatures,we hereby agree to abide by all terms and conditions of this agreement,
Including Building Division Policy,which is incorporated herein by reference.
3. All conditions and requirements listed in the attadied document entitled"Requirements for 30 Day
Power for Testinr Have ken,fulfilled and the premise is ready for compliance inspection..
4. All reques.ts for on extension beyond 30 days must be•.made in writing to the Building Ofl'idal stating
the reason for the request. Power may be removed from.the site and/or a Stop Work Order issued If
the r-ir<atinspecbon has not Dean approved vOin 30 days. A fee of$100.00 will be requited to 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 T 0 THE
DISCOMEMON OF ELECTRICAL POWf k-IN TH'F EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE DATE
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G �CCNMTRACM* DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE