HomeMy WebLinkAbout30 DAY POWERImportant: The occupant of the property (or other appropriate party) shall have made proper
application to the electric utility, paid any applicable fees or deposits, and requested power in a
timely and informed manner. St Lucie County is not responsible for any delays in the receipt of
electric power.
We acknowledge and accept the terms of this permission. We fitrther acknowledge that violation
of this agreement or a finding of unsafe conditions and/or practices found on the site or occupancy
of the site may result in immediate disconnection of this temporary power without warning and
hereby release St Lucie County and all representatives of any and all liability resulting from us not
abiding with this agreement.
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Print Name - Electrical Contractor Company Name
DocuSlgned by:
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Signat re - Electri al Contractor Date ftzw tw4F-OOwner Date
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Print Name - Electrical Contractor
Phone Number - Electrical Contractor
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License # Electrical Contractor
ignature - Prim Contr or Date
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Print Name - Prime Contractor
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License # Prime Contractor
Approved for St. Lucie County by:
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Print Name - Owner
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Phone Number - Owner
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Print Name - Prime Contractor Company Name
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Phone Number - Prime Contractor
Signature - Electrical InspectorBO Insp ID #
Inspector comments, limitations and restrictions:
Date
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