HomeMy WebLinkAboutpower releaseS T, L UCI E
COUNTY �
F L 0 R I D A -
Planning & Development Services
Building & !Code Regulation Division
2300 Virgi�ia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date: f Z - ZZ J ZOZ Permit Number: _ Z O �! ,078 8
Project Address: ,�-3-757'_ a-_-�---
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POINER TO THE ABOVE DESCRIi3ED
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 CONS ID.=_RATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
I This tempera.y power release i; requested fa the above stated purpose on-+, and thr ra wr'I be no
occupancy of any type, other than that permitted by construction during this time period
Z As witness try our signatures, we hereby agree to abide by all term; and conditions of this agreement.
including Building Division Policy, which is incorporated herein br reference-
1 AM conchbom and requirements listed in the attached docurnent entitled .R2quu ements for 30 Oa f
Power for Testing" have been fulfilled and the prenuse is ready for compliance inspection
4 All requests for an extension beyond 30 days must be made In vmhru3 to the Budding Official staN19
Ow reason for the request. Poa;er may be removed from tt a site and,,o. a 5t€p Work Order IsSu;-d If
the Final Inspection has not been approved within 30 days. A fee of $100 00 will be required tc lift
the Stop Work Order_
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST LUCIE COUNrr, AND 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 [N THE EVENT OF VIOLATION OF THIS AGREEMENT
-Z-3~2oZ /
nR1IG1 JURE DATE
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GENERAL cotirmkrOR SIGNATURE DATE
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ELE[TRicAL CONTRACTOR SIGNATURE _ DATE