HomeMy WebLinkAbout30 Day Temporary Power Release[Nai nijing fifz Devello` ianient Services
C B uNding Code Regulation Division
16101111111111011 2300 Virg Wa Ave
f�ori: (Pierce, Ili. a&i•NdZ
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I etdaiea lr 0� ady u elrnpporai°y Power me9ease
Date: Permit Number:
Project Address: S1yei 0(A.
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
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release Is requested for the above stated purpose only, and there will be no
occupancy of any type, other than that permitted by construction 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 incorporated herein by reference.
3. All conditions and requirements listed in the attached 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 the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order Issued if
the Final Inspection has not been approved within 30 days, A fee of $100.00 will be required to lift
the Stop Work Order,
WE HEREBY RJ.E SE AND AGf3EE TO-HOtr
ALL LIABI�ITfES A D C� AIMS OF ANY TYPE
OF TFjIB'TRANSA JCN, INCLUDING ANY A
SIGNA
HARMLESSSTLUCIE
, . COUNTY, AND THEIR EMPLOYEES FROM
�F NATURE WHICH MAY ARISE NOW Mill THE FUTURE OUT
MAGE WHICH MAY BE INCURRED DUE TO THE
THE EVENT OF VIOLATION OF THIS AGREEMENT.
DATE
DA E