HomeMy WebLinkAbout30 day tempPlanning & Development Services
Building & ICode Regulation Division
2300 Virgi is Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-pay Temporary Power Release
Permit Number: _ a n
Project Address: S3
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE D=S�r,I?_r,
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF � ES-I+NG 5`i -TE"S
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION, IN CONSIDEPATION oia w��Kt_)°�: � (-1'- Tic
REQi;_5T WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1 This tempura-}' power release is requested for the above stated Putpose on:-,y, acid there v,.
octupanC�, of any type, other than that permitted by construction during this rime pe-,ra
�- As witness by our signatures, we hereby agree to abide by all term; and cardttirans of this aC-Eer-erlt.
including Building Division Policy, which is incorporated herein by rerereru_e.
3. 41i conditions and requirernen's listed in the attached document entitled "Regjirements iFir ?:_ :-a,
Power for Testing" have been fulfilled and the premise is ready for cornp!iance tnspect icn
-1. Ali requests for an extension beyond 30 dz)ys must be made in vgiting to the 601,11N Orficel
tF,P reason for the request. Power may be removed from the site any;,. a- a Szop 'vb'Jr� Of der •<;;,:�,-,f
the Final Inspection has not been approved within 30 days. A fee of $100 09J wi;l b2
the Stop Wark Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST• LUCIE COUN rr', AND THEIR EMc_�)YEES F-, ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FJT-JRE COT
OF THIS TRANSACTION, INCLUDING, ANY DAMAGE WHICH MAY SE INCURRED DUE 70 THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIti AQ EE,yEN-
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SIGNATURE
3-1-21
DATE
GENERAL CONTRACTOR, SIENATURE
DATE
LECTRICAL CONTRACTOR SIGNATIJRE