HomeMy WebLinkAbout2021-12-16 09-11_page_1Planning & Development Services
Building & Fode Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462.6443
Request for 30-Day Ten-iporary Power Release
Permit Number: _ a In ci -n -1 n !)
Prolect Address: R
HE LINDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DcSCRI3EO
MOPER'Y, FOP, A PEKIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING Sy5TEM5
A%,�� EQJIPMEN r IN PREPARATION FOR A FINAL INSPEMON. IN CONSID=RATION 0= A,PkOVAL Or- THE
REQ 'ES flit HE:=6y AO�NOWLEDGE AND AGREE AS FOLLOWS:
-tiffs tenrti,-a 1, p,)WE, rElease r; 1
eque57ed for the above statP7
th::upann n` an; Pu Pose orlry, and the e v,
W , other than that perrnrted by construction during this time per,x
ti v.i;r�cc t'Y Our signatwes, we hereby a;rrE to abide by all term; and conditions of rh-; a;,em:ent.
'•'c'uo''ln &Mdinq D:vtsron Policy, which is incorporated herein by reference.
G1. o^d,; ons and iequ,reilens listed in the attached document entitled "Regjirzmenrs fi• .r 1Qr
-'Uwe- `Of -estinc•• have be*n fulfilled and the p,em,se is ready for ComplOnce msrVct,an
41, -equest-, for an e_rtens+on beyr;nd 30 days must be made in Yrr,ting to the Building
t*f reason for the reouest. Power rray be removed from the site and:,o: a St yGYc r� sta
•`.r F1'161 InsPectlo,i has no' been approved w!thin 30 days. A fee or `� y'+orT Crdc S'`"' ,r
"`e Stop ��1lF Oroer. 3100 Ql) Will be rez. ': -
VVE HE-,fav RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE CO � - R
A�L LI/-E;,ITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY APJ Er NOW OR 1N THc - -iTc; 5 ►^ l Or "'I= 'GL'�SkCTICN INCLUDING AfJY DAMAGE WHICH MAY BE INCURRED DUE TO THER_ l'�.T
D—ISSC01NN_C,70t, OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS r1GREENIEN—
::El 1Z
RATE l
TP,4c-, Si(.r�ATUR[ -----
0 11
ELECrNJ�,t CUtJTkACiUR $1;WAIURE _� 0a
0-Nrt --