HomeMy WebLinkAboutpower releasePlanning & Development Services
Building &ICode Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date: _ 14 —2 3- 2021
Permit Number: 2 / (3 3 ` (0 / SZ
Project Address: SqS 4a
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE D=SCRIBED
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 CO"ISIDERATION OF APPROVAL OF: THE
REQUEST WE HER,=BY ACKNOWLEDGE A.NO AGREE AS FOLLOWS
! This temporar}, power releas: is +equested for the above stated purpose onry, and there wl;l be rio
occupancy of any tyke, other than that permuted by �.,omtrucbon during this time pefiod
2 A, witness by our signatures, we hereby agree to abide by all term; and conditions of this agreement,
including Building Division Policy, whrh is incorporated herein bi reference.
3. Al! conditions and jequiremerits listed in the attacked document entitled "Regairemenls for 31) Day
Power for Testing' have been fulfilled and the pienuse is ready for comfdiancc rnsrect,on
4 All requests for an extension beyond 30 days must be made in vaithng to the Building Official stating
the reason (or the request. Power may be removed from thc- site and'o: a 5:rp Ylork Order issued if
the Final Inspection has not beer; approved w�thin 30 days. A fee of $100 W will be required tc lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST LUCIE COUNPr, AND THEIR EMPLOYEES FROM
ALL LIABILJTIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTICN, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVEPIT OF VIOLATION OF THIS AGREEMENT
TURE
2Qz i
DATE
2-23 - 20 Z /
GENERAL CON-MACTOR SIGNATURE DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE