HomeMy WebLinkAboutREQUEST FOR 30- DAY FORM OFFICE 01-032 22 10:45 FROM- 7728787656 T-887 P0001/00.01 F-654
Planning .&Development Services
Building Code Regulation Division
�:.UN 2300.Virginia Ave
Fort Pierce, FL. 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Perm t dumber: iZ.•
Project Addr4Bss: `\� �C> S
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:
1. This temporary power release is requested for the above stated purpose only,and-there will be no
occupancy of any type,other than that permitted by construction during this time period.
2. As witness by our signatures,we hereby agree to abide.by all terms and conditions of this,agreement,
including Building Division Policy,which is incorporated herein by reference.
3.' All conditions and requirements listed in the attached document entitled"Requirements for 30 Day
Power for Testing"Have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be•,made in writing to the Building Official stat rig
the reason for the request Power may be removed f om the site and/or a Stop Work Order issued If
the Final'Inspection has not been approved within 30 days. A fee of$100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILTITES 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 ELECMCAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE DATE
GFAI CONTRACT DACE
DATE
ELECTRICAL CONTRACTOR SIGNATURE