HomeMy WebLinkAbout30 Day Temporary Power Release=� St. Lucie County
Building & Zoning Department
R 2300 Virginia Avenue
Fort Pierce, FL 34982
561462 2165
Fax 561-462-1148
Request for 30 Day Temporary Power Release
Date: I Permit Number:
Property Address: 200 L
I
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
ABOVE DESCRIBED PROPERTY, FO� A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR
THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR 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.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
THEIR EMPLOYEES FROM ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
WHICH MAY ARISE NOW OR IN THE FUTURE OUT OF THIS TRANSACTION, INCLUDING
ANY DAMAGE WHICH AMY BE NCURRE DUE TO THE DISCONNECTION OF ELECTRICAL
POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
SIGNATURE
DATE
DATE
CONTRACTOR SIGNATURE DATE