HomeMy WebLinkAbout30 Day Temporary Power Release08/26/2015 12: 05 77287P7r5
11/19/2014 10.20 7726`
WYNNE BUILDING QQR'
WYNNE BUILDING P
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St, Lurie County
Building & Zoni ug Department
2300 Virginia Mmue.
Pod Piace, FL 34M
772.463.2I65
FaX 772-462.6443
Request for 30-Day T=Vorax3 Power Release
Pate: PeruAt Number: �S �k -'. � �k,o5
PrQpgty .Address:
THE UMERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
ABOVE DRSCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR
THE P(MpOSE OF TESTING SYSTEM$ AND EQUIPMENT IN PREPARATION FOR UNAL
INSPUCTION. IN CONSIDE"TION OF APPROVAL OF THE REQUEST'WE HEREBY
ACKNOWLEDGE AND AGREE AS FOLLOWS:
A. This temparary power xeiease b requested Jbr rite above stated purpose oni<p,
and thiwe w 0l. be no occupa)" of any Lytle, other than that pexudtted by comtruetion
daring this tune veriod.
2. As witness by adr �patures, we hereby agree to Abide by all bums and condit50n9
of this ugreeaAeat, including Budding D WW*a Policy, whicbt iu incorporated hewein by reference.
3. & conditions and requirements listed in the attached dacument entitled
" Require=nts for 30 Day Yower for Testing" bane been Milled and the pnrWse is ready f9r compiimee inspection.
4. ,All requests Ior an extension beyond 30 dsrys must be MR40 in writlug to the BuOdipg 00ciai statSag the reason
for the request Power may be removed bYom the site and/or a Stop Work Orda issued if *8 Final buspectton
has not been approved within 30 days. A fee of $100,00 wilt be required to lift the %p '/'York Order.
'WE B EREBY RELEASE .AND AGREE TO BOLD HAIYLES$, ST. LUCIE COUNTY, AND
THEIR EMPLOYEES FROM ALL LIABILITIES ANDCLAIMS OF ANY TYPE OF NATURE
FYMCH MAY ARISE NOW OR Ili, THE F'UTCJI.tE OUT OF THIS TR&NSACTION7 INCLUDING
ANY DAMAGE NCH MAYDE INCURRED DUE TO THE DISCONNECTION OF
ELECTRICAL POWER KM EVENT OF VIOLATION OrYTHItS AGREEMEI+TT.
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RECEIVED AUf..2 6 ?n4c