HomeMy WebLinkAbout30 days for testingPlanning & Development Services
Building & IICode Regulation Division
2300 Virgin is Ave
Fort Pierce, FL 34962
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date, _12 - 2 2- Z.6 Z C
Permit Number. 210 `/= a 3 Z-7_
Project Address: 57-1V2 _ ri TaP_ _sl.
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 CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS
! This tempora y Power release is requested fo. the above stated purpose on*, and there will be no
oaupancy of any type, other than that perrm;ted by construction during this time period
2 As wi1,ness by our signatures, we hereby agree to abode by all term; and conditions of this agreement,
including Building Division Polity, which is incorporated herein b'o Tefe:ence.
3 All conditions and requirements fisted in the attacked document entitled 'Regiirements fur 30 Day
Pourer for Testing' have been fulfilled and the pienase is ready for compliance inspection
4 All requests for an extension beyond 30 days must be made in ranting to the Building Official stating
the reason for the request. Power may be removed from the site and,.or a Stop Work Ordef rssup-d if
the Final Inspection has not been approval irthin 30 days. A fee of $100 00 Wii be required to (A
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, ANO 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
TURF
1
GENERAL CONTRACTOR SIGNATURE
ELECTRICAL CONTRACTOR SIGNATURE
/2-22-zoz /
DATE
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DATE
Z-2Z-e-Qz
DATE