HomeMy WebLinkAbout30 Day Temporary Power ReleaseRECEIVED
NPAY 14 2018
eve op -me pert
BuI.K.
l. U OMT. Lucie County, Permitting
dd
la
Ave
Folic'".10e.0i i -I.; Ot 6,r:
M46-2-41"69 Fax' 772;-462-6443
PbWerktledse
Data: Perri* Vimber., Q0
Prcled Address. <� 0\
THE UNDERSIGNED HEREBY REQUE$7F RELC-ASE or- aE=cAL PoWEp, To THE ABOVE DESCRMED
PROPERTY, FOR A PERIOD NOT TQ EXCEEa THIRTY (.3()) -pAyS, FOR THE PURPOSE OF*TESTING SYMMS
AN O EQUIPMENT IN PREPAl 0.N -FOR A RIVALINSPE =.N. IN CONSW8RAMON OF APPROVAL OF THE
REQUr WE'HERBY AdMOWLEDtE AND AG"KEE AS FbUOWS- *
I- this temporary Power rel6ase is• requested for the above Stated purpose, only,, Ond tee wifl be no
occupancy of any tVM ether th8n that Pemitted 4Y COhs'=WOn during this tiM6 period,
2. AsVitness by our sitgrr4tures, we herft a9fqa tb abide by all tons aril conditions of this agreement,indudihig Building Division Policy, which is incorporated her In by nQference,
3. Aff conditions and reqLdrem4nts fisted' in thie atta .6, ed document ent-ided 'R6qulrem.ents -lbr 30 Day
Power for Testinqff hve'bem fUffllled"a'rid the premise is, ready for,compliance inspection.
4. AJI rdquests foraneXtension beyppd 30 days must be'made in writing to i:he 8diding'Official stating
the reasorf for the request. PdWer r nay'be removedfrom the site andfor a Stop Work;0rder'issued V
the Fjna1'1nsp6M6n has not been -approved 'within 30 days. A fee of $100.00 will be requirtcl to lift
the Shop -Work Orden
WE HEREBY RELEASE AND AGREE TO HOD HARMLE. S, ESL LUCIE COUNT' , AND THEIR EMPLOYEES FROM
ALL LIABILMES AND CLAIMS -OF ANY TYPE. OF NATURE VVKCH MAY ARISE NOW OR IN' THE FUTURE OUT
OF-"1119$.TR.-ANSACriOrl,,INCLUDING ANY lY"V35VM'.. Xji-'-NW 13E INW. WE TO THE
RRED.
DISCONTC-=N OF ELECTRICAL POWER IN. THE EVENT OF VIOLATION OF Tjjm AGREEMENT
08Z-. M00/3000d 906-1 . 999L8LELL _W0dj 08:0L KI-tL-90