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FPL
Date:
To:Florida Power&Light Company
Re: Authorization to Connect Electrical Sei vice
Please accept this notification as authorization to connect the electrical service at:
(project name and location)
I hereby certify that the electrical installation has been inspected by a licensed electrical
contractor and meets or exceeds all applicable requirements of all applicable codes. I certify that
I am authorized to grant FPL authorization for FPL to connect the aforementioned electrical
service to FPL's electrical distribution system based on the following condition of exemption.
Facility is on Agricultural zoned property pursuant to Florida Statute 193.461
❑ Facility is on property owned by a railroad company
❑ Facility is on property owned by a government entity
❑ Emergency repair work subject to inspection within 48 hours after connection
❑ Other
By: Electrical Contractor's License#, F.(— W43
Signatt Authorized Representative)
(Print orType Representative's Name)
Title:
Customer(Print or Type Name of Organization)
For FPL Use Only
CIS Address
CIS Account#
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REVIEWED FOR -_ST.LUdIE�
- 00DE-OOMPLIANCE-COUNTY--------
PLAN REVIEW
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