HomeMy WebLinkAbout30- day request for power 01-19--'22 11 :11 FROM- 7728787656 T-910 'P0002/0002 F-690
Pl$nrrr*.&Dev0oplrrrtl:nfi SeMces
saitilino &bode Reg��aLion Div"Won
2300:1 o' ' is Ave
fi+ .
FOrt-PildMe; K 34ft .
772-462-2165 Fax 772-46 2-6443
Regis -for 30-day Temporary Power Retease
Date: : "�'� Permit Nom,ber:ID,
Project Address: Q_Q•r.,;:� Q
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FOP,A PERIOD NOT TO EXCEED THIRTY(30)-DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A.FNAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HERL9$Y ACKNOWLEDGE AND AGE AS FOLLOWS:
1. This temporary power release is requested far the above stated purpose only,and tw&e wtTl be.no
occupancy of any type, other than that permitted by construction during this time period.
2. As witness by our signatutes,we hereby agree do abide by all terms and conditions of this agreement,
including Building Division Policy,which is ineorporated herein by reference.
3. All conditions and requireme;►ts lis-Md in the attached-docurnent entitled"RequiremenM for 30 Day
Power for Testing'Have been'futflfled and the premise is ready far compliance inspection.
4. All requests for an extension beyond 30 days must be,made in wnbng to the Building Official sting
the reason for the request. Power maybe removed'from,the site and/or a Stop Work Order issued if
the Fnal'Inspetton 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 DAMAGE1NFiICH MAY BE INCURRED DUE TO THE
DISCONNECnON OF ELEL?iZICAL POWER IN THE EVENTOF VIOLATION OF THIS AGREEMENT.
OWNER SIG 9A'AJ
G COiVYl2ACT0iY DA
ELECTRICAL CONTRACTOR SIGNATURE DATE