HomeMy WebLinkAbouttemp powerPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Dare: 14 -?- permit Number: _2l a 3 _ O / 5-2
Project Address: S'3Y--C--��—�
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELEC TRICAL 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. fN CONSIDERATiON OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
!. This temporary power release is requested foc the above stated purpose wiry, and there will be no
occupancy of any typp-, other than that permitted by construction during this time period.
2. As witness by our signatures, we hereby agree to abide by all tern; and conditions of thi; agreement,
including Building Division Policy, which is incorporated herein bi reference.
3. Ali cor!ditioP5 and requirements listed in the attached document entitled "Reciuiremenrs for 30 Day
Power `or Testing" have been fulfilled and the premise is ready for compliance inspection
IAll requests for an extension beyond 30 clays must be rnadQ in venting to the Building Official sta'.ing
the reason fof the request. Power may be removed from the site and,:o: a Stop Work Order issued if
the Final Inspection has not been approve! w-thin 30 days. A fee of 3100 00 will be required to bft
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNT^f, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE N01N 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
►GNATUR
GEtVERA.L COI�TRACTOP. SIGNATURE
ELECTRICAL CONTRACTOR SIGNATURE
12 - 2 ,3 - 2 a z /
DATE
-23 -
-DOTE -- -
- Z-J- 2 o z /
DATE