HomeMy WebLinkAbout30 Day Temporary Power Release 02-08-- 22 14:44 FROM- 7728787656 T-961 P0001/0001 F-758
Planning a.Devdopment Services
BUild rig bd.e regulation Division
230�0:�/ir+gfnia Ave
Fork:Pje;ce; F.4 34082
7 2- � fax 772-462-6443
72-4fi fi
Request for 30-Day Temporary Power Release
Date: �S \� Permit Number:
Project 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:FINAL-INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
R,EQUEsr we HERBY AcmowLi_DGE AND AGREE AS FOLLOWS:
1. This temporary power release is roquested for the above shed purpose may,and titers will be no
occupancy of any type,other than that permitted by con4trucdon 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 indorporated herein by reference.
3. All conditions and requirements listed in the attadted document entitled"Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for compliance inspection,
4. All requests for an extension beyond 30 days must be-made-in writing to tft Building Official stating
fYte reason for tie request. Power may be removedfrom the site arid/or a Shop.Work.-Order issued if
the Final•ILon has not been approved within 30 days. A fee of$100.00 Will be required to lift
ft Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST.•LUQE COUNTY,AND THt IR EMPLOYEES FROM
ALL LTABILTIIES AND.CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF TN3S TRANSACTION, INCLUDING ANY DAMAGE'WHICH MAY BE INCURRED DUE TO THE
DISCOi11AlEMON•OF ELECT CAL POWER IN THE EVENT. OF VML-AI70N OF THIS AGREEMENT.
OWNER SIGNA DATE
CONTRACTOR !29` DATE \
p.EC7RICAl CONTRACTOR SIGNATURE DATE