HomeMy WebLinkAboutpower release+COU NTY
F 1 0 P. I O A
Planning & 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
Dave - -9 _ a a— _ Permit Number: _ a 10t� _O A01
Project Address: _ y -A _hA _�
C- .'e
,c -�ERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POVNER TO THE ABOVE DE5CRI9ED
PRC` E;! ", FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AN.; E-`JIPMEN7 IN PREPARATION FOR A FINAL INSPECTION. IN CO"JSIDEFRATION OF APPROVAL OF TFiF
RE-_ -`' WE HE;.=BY ACKNOWLEDGE AND AGREE AS FOLLOWS:
-`is temnora y power r_Ieas is requested for the above statel purpose o��iy and there ti;,'1 be no
:upar,Cy of any type, other than that perrnitted by construction during this ame peril.
AS witness by our signatures, we hereby cl;ree to abide by all terms and conditions of this age?ment,
ir:cluding Euitiding Division Policy, which is incorporated herein by reference.
41i coldit ons and requiremen`.s listed in the attached dxurnent entitled "Regjirements for 3i, ;jey
-ower for 7estinq" have beTn fulfilled and the premise is ready for compliance inspection
A" -equesL for an extension beyond 30 days must be rnade in writing to the Budding Gffical sta_i.,g
the rFason for the request. Power may be removed from the site. and. a, a St(V Work Order issuec; ji
try Firial Inspection has not beer; approved within 30 days. A fee of
:''e Stop V"Ork Order. $ I00 0+.) will be reqnra,, cc ! ft
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNPr,
A-L LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISENON, OR IN HE FOTUR Fn�
OF THIS TRANSACTICN, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE ' OJT
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREE.MEN
�1\
1;NATu?=
GE-NEP,AL COtdTPACTC P. SIGNATURE
ELECTRi Cfih ONTRACTOk 51 )NATURE
3 -9 - 2 2-
nAT>E
3
(DATE
-S-kga ,
U.4IE -------- ----