HomeMy WebLinkAbout30 day power releaseP n''jh"& D lopmgnt-_:Servfces
gulldin'g & Code. Regulat'id h Division
2 V1
900 . rginta Ave
Fort. Pferce,, FL 34982
772-462-2105 Fax 772-462-6443,
Request Ternpo*v Pdiqer Release.
Date: t,12 —30—. .2-C,717 :, I . . I z::) �/ — 03
ftrralt �NUrnber:
Property Address:' Af U-"
THE UNDERSIGNED HEREBY RE -QUEST RELEASEORELECTRICAL-POWgR TO THE ABOVE DESCRIBED PROPERTY
,
K . ..
FOR A PERIOD NOT TO EXCEED THIRTY (30.) DAYS-, FOKTHEPURPOSE OF TESTiNG'SYSTEIVISAND EQUIPMENTS
I.
E IN PREPARATION FOR FINAL INSPECTION. IN CONSIDERATION OF-APPR6vREQUEST AL -OF THE U WE-H REBy
ACRNOWLEGE AND AGREE AS FOLLO, W-S.
1. This temporary power r0104 els: requested
for the above state purpose- only, and there will be. no
ction during this time period.
occupancy of any type, other tha hlhtft Pormitte. ru
�2. As witness bLour signatures, we., h6reI)y-agree to.abldeby all terms and conditions of this agreement;,
including Building Division Policy, wbj,h , 'incorporated. her6in b reference.
erence,
.3, All conditions and requiternetnts listed: in the attached document entitled "Requirements for. 36 bay
Power for Testlnie `bavebe'eri f.ulf-.1116.d:arid*the:>"p'rem'Lse.l*s ready -for compliance inspection,
4. All requests for a.n. exte0isfon beyoh&30days . must'be:mado In Writing to the Building Official stating
the reason. for the request: Power may �e removed from the.'s -and/or a Stop Work Order issued If
..y Ito:.
the Final Inspection has: notbeemapproved within 80-clays. Afee, -of $1.6 w. -the
0 ill be required to'lift
Stop Work Order.
WE HEREBY RELEASE AND AGREE TO :HOLD HAR.Mt-65- �ST LUCIE COUNTY-,. AN
I I w .� .''. , . D THEIR EMPLOYEES FROM ALL
LIABILITIES AND CLAIMS OF. ANY TYPE NATURE MAY ARISE tNO.W OR.. IN THE FUTURE OUT 01~THIS
TRANSACTIQN, - INCLUIDIN - G'ANY DAMAGE WHICH MAY' BE -INCURRED DUE TO THE DISCONNECTION
ELECTRICAL POWER IN THE EVENT OF VIOLA-MONOF THIS AGREEMENT.
-2 ;7—
OWN ERSIGNATURE
DATE
07
GENEPAL CONTRACTOR SIGNATURE; DATE
-07-17
ELECRICAL cbNTRACTok SIGNATURE
DATE