HomeMy WebLinkAbout30 Day Temporary Power ReleaseFtanning & Development Services mepartment
Building & Code Regulations Division
2300 Virginia Avenue
Ft Pierce, FL 34982
Phone: 772- 462-2165
Fax:772-462-2522
Request for 30-Day Temporary Power Release
Date: �/3���- Permit Number: 12
7
Project Address: 76/o 1-lee %/..¢ 491 Lt . `/ • Pr see- I - 7YFYr
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 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
4. Testing" have been fulfilled and the premise is ready for compliance inspection.
5. All requests for an extension beyond 30 days must be made in writing to the Building Official stating the reason
for the request. Power may be,removed from 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 LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
WHICH MAY ARISE NOW OR IN THE FUTURE OUT OF.THIS TRANSACTION, INCLUDING
ANY D + WHIC BE INCURRED DUE TO THE DISCONNECTION OF
ELE RICAL PO R HEST OF VIOLATION OF THIS AGREEMENT.
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s`y; . SIGNXT
SIGNATURE
SLCPDSD Revised 06/14/2010
DATE