HomeMy WebLinkAboutRequest for 30- day temp power request 01-1.8-'22 10:`59-FROM- 7728787656 T-908 P0001/0002 F-687
Ptann'in§".&'Development Services
Buifdin Code.0 R�eguiation ®6vis�ion
230 :Y%gi ala-Av-p
Fort Pierce, FL 34982
772-462-2145 Fax 772-462-6443
Req
uest.-for 30-Day--Terhpgi-ary'Power,Relftse
Date: v - Permit Number:
ect Address;
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.tNAL INSPEmON. IN CONSIDERATION OF APPROVAL OF THE
REQUEST"WE Repmay Ackkow' LeDGE AND AGREE AS FOLLOWS:
Z. This to v ry power r*we is requested,for the above stated purpose only,and tTiere will be no
occupancy of any type,other than'that permitted by construction during this time period.
2. As W&ms by our signatures,we hereby-agree to abide by all twms and conditions of this agreement,
induding Bonding Division Pdky,which is incorporated herein by relbr+ence.
3. All conditions and requirermerits listed in We attached document entitled"Requirements for 30 Day
Power for resting"haveteen_futfiDed and the premise is ready ibr compliance inspection.
4. All requests for an extension beyond 30 days must be.made in writing to the Bullding Official s=ng
the reason for the requEsL Power may be removed from.'the site and/or.a Stop Work Order Issued if
the Final'Inspe�ction has riot been approved within 30•days. Afee'of$100.Do will be required bD lift
the Stop Work Order.
- WE�Ht=REBY RaiE� E AND AGREE TO HOLD HARMlF55,ST. LUQE COUNTY,AND THEIR EMPLOYEES FROM
ALL LTABRTT TES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT -
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICHMAY BE INCURRED DUE TO THE
DISOONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF TMS AGREEMENT.
OWNER SIGNA'FUR DAIS
GONT 4L"'T01� RE DATA
ELECTRICAL CONTRACTOR SIGNATURE DATE