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i�tanr�ing �� �evetopxt�en� Se>r�rice�
�uiiding 8� Co�e:�.eguta��on ®ivi�ior�
2�Og !lirginia Ave
�o>r� Pi®rce, Nr�, 34��2
iReque�� for �o��ay� �'ernnporal�y �ornre�- �etease
Dale; 02/03/2022 Pertinit Nutnbei : 2107-0003
Project Address: 5218 Armina Place, Fort Pierce
THE UND�RSZGNED HER�13Y REQUEST RELEASE OF ELECTRICAL POVI/ER TO l'HE ABOVE p�SCRIBED
PROPERTY, FOR A PERIQD NOT TO EXCEED THIRTY (34) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION fOR A FZNAI. INSPECTION, zN CONSIDERATION OF APPRC)VAL OF THE
�tEQUEST WE HEREBY ACI<NOWLEDGE AND AGREI; AS.I=QLLaWS;
1: This temporary power release is requested for tt�e above stated purpose only, and fihere will be no
occupancy. of airy type,�other than that permitted by construction during fihis,time period,
2. As .wlthess by tour signatures, we hereby agree fiv abide by all letrns a�td conclltions of t��is agreement,
including Building .Division Pallcy, �wliich is f ncorporated herein by -reference.
3. AIf conditions and requlremenrs listed in the attached document entitled "aequlremenls for 30 Day
Power i:or Tesfiing"have been fulfilled and�fihe premise is ready for• coinpliance�inspecfilon•
h. All requests for• an extension beyond 34 days must be made (n writing:to. the Building Official stating_
the reason foi• the request,- Power may be removed from the site and/or a Stop INot=k order�lssued if
the Final Inspectl9n has nafi been approved within �o days. A .fee of $iQO.QQ will be required to lift
the.stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST, L11CIE.000NTY, AND THEIR EMPLOYEES FROM
ALL LTABILTTIES AND CLAIMS OF ANY TYPE OF NATURE UVHZCH MAY ARISE. NO1N OR zN THE:FUTURE OUT
OF THIS TRAi�SACTION, INCLUDING ANY DAMAGE 11VI-IYCH MAY BE YNCURRED DUE TO�THE.
DISCOIVNECTiON OF ELECTRICAL.I?�OWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT,
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�.,__, / � f' ���VIn j3QI•lcc��l�a���► 10/14/2021
OWNER I N .�tE t~""� DATE
�osopii spalt 10/14/2021
GENERA _. i C�ACTOtt SIGNATURE QATE
10/14/2021
ELECT. ICAL CONTRACTOR;STGNATURE PATE