HomeMy WebLinkAboutREQUEST FOR 30-DAY TREMP POWER RELEASE FORM 10-13-'21 11 :04 FROM- 7728787656 T-631 P0002/0008 F-348
k Planning'. t'.—IMeJopment Services
_ BtuildlAj -R�qulaifion Division
23Q0:10irgnmia Ave
n Fort Plefte, FL 34ft2
772-46Z4 66,`5 Fax 772-46Z-6443
Regcilesi-for 30-Day Power Release
Date:
Prqed Address, \q ..� e�� • .tom.sLcs� —�c�1
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FORA PERIOD NOT TO EXCEEDTHIRR iY(30) DAYS,FOR THE PURPOSE OF TESTING SYSTEMSAND EQUIPMENT IN PREPARAJIO.N FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HE Y ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This tempmry power relese is Mquested for the above stated pose only,and there will be no
occupancy of any type, 6t ter then that perMitted by phso ction 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. Ail conditions and requirements.listed In the attaghed document entitled"Requirements for 30 Day
Power for Testngn have been fulfilled and the premise is ready for compliance inspettion.
4. All requests for arvextension beyond 30 days must be,made in wtiting to the Building OfF'idal stating
the reason for the request. Power may be removed from.the site and/or a Strop Worts Order issued if
the Finai'Inspecton has not been may
within 30-days.._ A fee of$100.00 will be required to lift
the Stop Work Order. .
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST. LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILTTES 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 TO THE
DISCOMEMON OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER VGWMTUR DATE
C
CON1RACrOR RE DATE
ELECTRICAL CONTRAMP.SIGMA-WRE DATE
i