HomeMy WebLinkAboutpower releasePlanning & Development Services
Building & IICode Regulation Division
2300 vir°giX Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date,
Permit Number; _ aloa-��,5 6.dS
Pro)ect Address: � 4.3 -CA
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DcSCRIBEE7
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TcSTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECT70 . IN CONSIDEr?;1TION O;r APrR(j+JAL OP T: iE
REQUEST WE HERBY ACKNOWLEDGE AND AGREE AS !70LLOWS:
This temporary- power releasy is requested for the above stated purpose or,iy, and there vi; I be no
occupancy of any type, other than that permitted by construction dunnj this time perv?d.
As witness by our signature;, rre hereby agree to abide by all terrn; and conditions of thi; agreement,
including Building Division Policy, which is incorporated herein b'r reference.
All conditions and requirements fisted in the attacfred dc-current entitled "Requirements for 3C, Der
Power for Testing" have beTn fulfilled and the pre��ise is ready for compliance inspection.
All requests for an extension be-yeind 30 days mast be made in vriting to the Building Official sta.,!n-
the reason for the request. Power rr?ay be removed from the site and,c, a Stcyp VVOrk Order ,ssu=-C' it
the Final Inspection has not been apuroved arthin 30 days. A fee of 3100 00 will be repo re,� t� I"
the Stop 4 ock Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE CQUNFY, AND THEIR EMP_GyEES Fr, -
A.LL LIAB]LlTIES AND CLAIMS OF ANY ll
TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE `UTJRE GOT
OF THIS TRANSACTION, INCLUDING, ANY DAMAGE_ WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF- THIS AGRE&NN ' T
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