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HomeMy WebLinkAboutpower releasePlanning & Development Services
Building & Code Regulation Division
2300 Virgi�la Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30--Day Ternporary Power Release
Date: _ �� I I:� _ Permit Number; _a t 0 �_" ©� 3
G�
Project 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 FINAL INSPECTION. IN CONSIDEPATION OF APPROVAL Or- THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS;
This temporary power release is requested for the above stated purpose oniy, and there viifl be no
occupancy of any type, other than that permitted by construction during this time period.
As witness by our signatures, we hereby agree to abide by all term; and conditions of this agreement,
including Building Division Polity, which is incorporated herein by reference.
All conditions and requirements listed in the attached document entit!ed "Requirements for 3#3 Day
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
All requests for an extension beyond 30 days must be made in writing to the Budding Official stabing
the reason for the request. Power may be removed from the site and'or a Stop 'Work Order issc - if
the Final Inspection has not been approved within 30 days. A fee of $100.0t1 will be required tc Eft
the Stop bVcrk Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE 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 BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
IGNATURE
GENERAL COhfTPACTOR, SIGNATURE
ELECTRICALCNTRACTOR SIGNATURE
DATE
1!-10-21
DATE
I I - 9 - a ll -.
DATE