HomeMy WebLinkAbout30 DAY TEMPPlanning & Development Services
Building & ICode Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date ' __ — Permit Number:
_ - 0, S 1.
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 CONSIDE: ATION 0 APrttClV L OF T: iF
REQUES 7 WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
! This temporary power release is requested for the above stated purpose oniy, and there vii:! be no
occupancy, of any type, other than that permitted by construction during this time pennd.
L. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
vic!uding Building Division Polity, which is incorporated herein by reference.
i. Ali cordrtior.s and requirements listed in the attached doc:urnent entitled "Requiremenrs fur 3G Day
Power `or Testing" have been fulfilled and the premise is ready for compliance inspection
Ali -equests for an extension beyond 30 days must be made in writing to the Bwldino OfTinal sta-.!,;
the reason for the request. Power rray be removed from the site and;or a Stop Work Order issues it
the r'irnal Inspection has not been approved within 30 days. A fee of 3100 0o will be require-, to !,,it
'he Stop b{`ork Order.
VVE HER-EBY RELEASE AND AGREE TO HOLD HARMLESS, ST, LUCIE COUNPi', AND THEIR EMP:OYEES FKJr4
A. -L LIAEILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OJT
OF THIS 7 RANSACTICN, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMEN'
TUR E ---
k
DATE
3- 2--zz
GENERAL C01,7PACTCIP. SIGNATURE DATE
_ 3- 3 -aoaa
ELECI"Rl C.An OtITPACTOR 5l3NATIJRE �'w VATE �+��