HomeMy WebLinkAbout 30- DAY REQUEST FOR TEMP POWER 11-05-'21- 14:28 -FROM- 7728787656 T-733 P0001/0002 F-470
Pt inn Opment Services
Bui'I�n &Cdft RegUlation Division
23001 9m,Ja Aie
Fort"Pidrcd FL 3492
772-462 21`65 Fax 772-462-6443
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Request for 30-Day'Tempora.ry Power Release
D'dtE, \� � `� Permrt Nambsr
Project Adds m;
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 FINAL.INSP,Ecrmm IN CONSIbERATION OF APPROVAL OF THE
REST WE NS:M.SY ACKNOVdMGE AND AGREE AS FOLIrOM:
1. This terr>pvrary power release is requested for the above skabed purpose only,and t ae Wdl be no
occupancy of any type,other than that permitted•by'00knbuciion during this time period.
2. As witness by otir signatures,we herdby agree tab abide by all terms and conditions of Ms;agreement,
including Su'lding Division Policy,which is incorporabad herein by reference. -
3. All conditions and requirements,fisted in the attached document entitled"Requirement for 30 Day
Power for Testing"h e been fulfilled and the premise is ready for compliance inspeLton.
4. All requests for an extension beyond 30.daysl must be:made in wriUng W the Building dal stating
the reason for the request Power may be ne. owd�from.the site and/or a Stop work order issued if
the Finai'irmertion has not been approved within 30-days. A fee of$100,00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HAP.MLESS,51".,LUCIE COUNTY,AIVD THEIR EMPLOYEES FROM
ALL LIABILMES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN TEIE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE'WHICH MAY BE INCURRED DUE TO THE
01SCONNEC ffON OF ELECMCAL POWER IN THE EVENT OF VIOLATION OF THIS AGIWMENT.
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OWNER SIGNATURE DATE
'CONTPAC'OIY RE DATE
ELECTRICAL CONTRACTOR SIGNATURE. DATE
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