HomeMy WebLinkAboutREQUEST FOR TEMP POWER RELEASE FORM 10-13-'21 11 :06 FROM- 7728787656 T-631 P0007J0008 F-348
P1tnrrM§-. 1:MVdlopMent Services
Btiilc�.i.n�'&bode,ftegulatia0 bivision
23O�D '1 i�lla Ave
Fort Pierce; FC 98
i7z-462-71,65 Fax 772-462-6443
Reque for 30-Day Temporary Power ftlease
Dater ��\� � Perifflt Number: Q$<<�-
Pro�ert Adder;
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FOR A PERIOD NOT TO ICEED THIRTY'(3.0)•DAYS,FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUESr M-HEREBY ACKNO1rATU=E AND.AGREE'AS FOLLOWS.
I. This twgxra V power release is requested for the above sWted puke only,and here wM be no
occ0pancy of any type, *er than that permitted by cobstrucbfln during,ft time period.
Z. As witness by our 4nat uees,we hereby agree tb abide by all Wrms and conditions of this agreement,
including Building Division Policy,which is indorporated herein by reference.
3. All condidons and requirements listed in tie attached document ent died"Requirements for 30 Day.
Power for Testing`have been fulfilled.and the premise is ready tor-compliance inspection.
4. All requests for an extension beyond 30 days must be..made in wrfing to the Building Ot cal stating
the reason for the request. Power maybe removed-from.the site and/or a Stop Work Order issued if
Me Final'Inspectibn has not been approved within 30 days. A fee of$100.00 will be required to rdt
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST, LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL L.IAB1TIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE'Wi ICH MAY BE INCURRED DUE TO THE
DISCONNECiI!ON OF ELECTRICAL POWER BY THE SEW OF VJOLATION OF-rh7S AGREEMENT.
OWNER SIGNATU DATE
+CONDOR DATE
ELECTRICAL CON7RACMR SIGNATURE DATE