HomeMy WebLinkAboutTemp Power Release pigntillig:and Development Services
07.
V .- Building and Code Regulations
_
.� 2300 Virginia Avenue
Fort Pierce,FL 34983
772-462-1553
Faz 772-462=6443,
TEMPORARY EARLY POWER:REUASE
QNameoffeiiant'ot,Owieer);:.
The,Tenant or owner rcquesis='St 4Lucie County Deve[opment Services:Department to,release the-.
electrical power-it` L(V,a L_ dN4 rJG E'�'(/ ,(address,including suitenttmber,
as posted:on the electric meter:and the building]for building perniit#2 1 03��Z Zfor the;
purpose of`construction-and,teshn �biAdin to
I
g. g sys ms,;including,air conditionng, refngeiattot>;
lighting,-power and control,circuits with the following stipulations;.
1". Iri co.mplcte:or untested'eirouits;are'NOTto be-energized:without properly,licensed electrical
personnel'on thejobsite sad no.systems are to remain energize , eyond the testing/temporary,
purpose`without proper linsnbyth CBuidinc SI _Departmen approgriately
lieensctper&op(s}:_,
2.-All panels and.disconnects,not in:use-mustbt'locked.in.the `OFF"-positionof fuses removed:
3.1 oper.procedures for lockgut/tagout must,br inplace,
4.The electrical equipment room(where_applicabie)wiltremain locked arail times with'thejcey in
the possession,of the electrical 4tractar.,-""
5.All fatal inspections relativeto the'closcout of'this project;must.be requested and passed in a
timely manner as determined'by the Electrical Inspector.aiid/or.the Building_Official..
6.The building may not be occupied before a Certificate ofOccupancy(C.O.);is issued:
7.Nq stocking of materials,otherthan those required.for construction is permitted by this agreement
8.1 No on-site occupancy of training of personnel employed by the gccupant�busine- entity or owner
is permitted byjhis agreement,
9.,No furaitunr;racks;fUmishings or other personal orcorporate.property is perm—ed'on site by this
agreement.
10; Construction power remains covered.by`the-requirements"for GFCI protection and all-d r
requirements.of the governing Codes,see_PJatidnal Electrical Code'(NEC)Article`590.
Violation�of this'agreement may result-in the immediate`tertninatiogofthe'eketncal power without.,
prior notice or warning to,the affected parties_This-form requires all.- f the following;signatures;
prior to povaer being released:The:undersigned"acknowledge�that the operation of air conditioning'
equipment;"whip✓,con$tructton is to progress may create or''Increase..itie%risk. of contamination or
preiYature=failure of the equipment:
The:undersignedacknowiedges;the above lsted'stipulattons,agrees to the terms of this_agreement
and agrees to hold St Lucie,County.,Harmless from..any damages.that may arise as a result,-of the
fel asc-of power to the premises.,The undersigned.hereby requests`powerao be;released for this
project.This form;does not guarante-. mer,which is atthe-discretion and`controYofthe,.electrical.
utility._
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Itnportanh Tlie occupant of Alik ProPeitY (or other alip ogriate party) sba11'tuvee.nnde proper
application to the electric utility,pud any-applicablg fees or-deposits,and i?egfieited power in a
timely and informed mwnere St Lucie County is not responsible for any delays in the receipt of
electric power.
We acknowledge aW iccept the tem.of this,p nisdon:,We.fiYtther aclaiowledge that violation
of"agreement or A Eroding-of unsafe conditions and/or practices famd on the site or oatipwwy
of the site may result-in immediate.disconnection of this temporary power without warning and
hereby release SfLucie County and all representatives of eay 04 all liability resulting from us.not
pry
abiding with this agreement:
Print Nime-Electrical Costrmtor;Company Name
SiSnituro- Contractor Date i„, -Own Date
/�#t�i":tiC 'mil�0�5 - - •'Print Nam'.Elec ttical Contractor Pant Naine-owner
Phone Number ont=tor Owner
3e�a7! D�s��?y
en a Contractor
t ure-Prime Contractor, Date Print Name-Prime Contractor Company Name
Print.Nam -Prime Contractor'. Phone Number-Prime.Contragw
rYN.1, Qn?2-7
License#Prune Conhactor°
Approved.for.St<Lude Coaaty by;_
Signature-Electrical InspectorBO Insp_ID#. Daft
Inspector comments,;limitations acid iest ic6oft'
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