HomeMy WebLinkAbout2021-12-20 10-03Planning & Development Services
Building & Code R gul tion Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date:Af� I �- �11 Permit Number: J0 Q (1 " y 9 0
Project Address: -5x r lLj....�U.
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATIO OF APP I V S
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSEYSTEMS
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS; ON OF APPROVAL OF THE
I. This temporary Power release is requested for the above stated purpose
on, an2. occupancy of any type, other than that permitted by construction during this time periodwill be no
As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy, which is incorporated herein by reference.
3. All conditions and requirements listed in the attached docurnent entitled "Requirements f g ment,
Power for Testing" have been fulfilled and the premise is ready for compliance inspection,
30 Day
4. All requests for an extension beyond 30 days must be made in writing to the Building
pection,
the reason for the request. Power may be removed from the site and/or a Stop Work Order issued if
the Final Inspection has not been a Official stating
the Stop Work Order. approved within 30 days. A fee of $100.00 will be required to lift
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS ST. LUCIE COUNTY, AND THEIR EMPLOYEES
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
M
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE r
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT,
IGNATURE
GENERAL CONTRACTOR SIGNATURE
ciF-i- i Mlk-ML WIN 1 KA(; I OR SIGNA
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