HomeMy WebLinkAboutREQUEST FOR 30 DAY POWER FORM 11-17-'21 11 :03 FROM- I 7728787656 T-760 P0002/0003 F-508
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Plnneil a•bweloprnenf Services
Buildng.SL SIC.jD4:k4gulation bin isidn
230d:� l�ia live
Fdrt••P6erte FL 392
JW 772-46 2-AS FaX 772-46'1-6443
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Reque-Alor 30-Day-Temp"Or"Ary•Power Release
Date., �. `� Perm i ur ber: �D ����
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 sysrvs
AND EQUIPMENT IN'PREPARATION FOP,A li•IM.TNSP.ECI 0N. IN CONSIDERATION OF APPROVAL-OF THE
REQUEST WE HEREBY ACi<NOWLED?='E AND AC4;tE•A8 FOLLOWS:
1. This temporary power r0ease is requested fci the above stated purpose only,and tbene WM be no
o=pancy of any type,other than that perni tted by construction du669'W5 time plod.
2. As witness by our signatures,we hereby agree to abide by all terms and conditlons of this.agreement,
jncludbng Building Division Policy,which is incorporated herein by reference.
3. All conditions.and requirem"listed in the•attad document Entitled"Requk mew for 30 Day
Power•for T.estingw have been fulfilled and the preen se is ready for compliance inspection.
4. Al requests for an a cMsion beyond 30 days must be:made in writing t D M.e Building Official stating
the r6aWn fbr the request. Power may be*-n. ed'from the site and/or a Stop Work Order issued if
Me Fnal•InspecUon has not been approved)within 30•days. A fee of$100.00 will be required to rrft
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL U48R TTIES AND CLAIMS OF ANY TYPE OF•NA lR �E WHICH MAY ARISE NOW OR IN THE FUNRE OUT
OF THIS TRANSACTION, INCLUDING ANY DAmAGE'liUi�'is MAY BE INCURRED DUE TO THE
D NNEC7ION OF ELECTRICAL POWER 3N THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE DATE
Q CONTRACMA i DATE
E1.EC`TRICAL OONTRAmp.SIGNATURE DATE
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