HomeMy WebLinkAboutREFQUEST FOR 30- DAY EMP POWER RELEASE FORM 10-13-'21 11 :07 FROM- 7728787656 T-631 P0008/0008 F-348
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Request for 30-Day Temporary•Power:Release
Date:
ect Address;.
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#'INAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REST WE HERESY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose only,and there will be no
Occupancy of any type,other than'that permitted Eby coi istruciion,during this time period.
2. As witness by our sigrtatlires,we hereby agree to abide by all terms and conditions of this agreement,
Including Building Division Policy,vftch is incorporated herein by reference.
3. Ali conditions and requirements.listed in the ettai hed document entitled"Requirements for 30 Day
Power for Testing"Have been'f lied and the premise Ls ready for compliance inspection.
4. All requests fnr an a dension beyond 30 days must ba•made in writing to the Building Ofridal staring
the reason for the request: Power may be removed'from the site and/or a Stop Work Order issued if
the C=inal'Inspection has not been approved within 30 days. A fee of$100.00 will be required to rift
the ftp Work Order.
WE HEREBY 4RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCI:E 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 13E INCURRED DUE TO THE
DISCONl lECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNAW DATE
76CONT7RACMR DATE
ELECTRICAL CONTRACTOR SIGNATURE l7ATE