HomeMy WebLinkAbout30 Day Temporary Power ReleasePia'00149 & -61 v4dopment SeWices
86-11din &'Code Rcguiation DIV Sion
2300 Afrginia Ave
Fort Pierce; FL 34982
772462=Z165 Fax 772-462-6443
RECEIVED
APR 0 4 2018
Permitting Department
St. Lucie County
t equest for 3Q-f3ay'Temporary Power ketease
Date: Pennit .. - f� t
Proje4Address: N '"k.,
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL_ POWER TO THE ABOVE DESCRIBED
PROPERTY, > OR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF'TESTlNG S'y$-mMS
AND EQUIPMENT IN PREPARATION FOR A .FINAL INSPECTION. 'IN CONSZERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEbiGE AND AGktE AS F011OWS:
I- this temporary power release is -requested for the above stated purpose only, and there will be no
o=pancy of any type, other than that permithed by coiistruc4on during this time period.
2. As witness by our signatures, we hereby agree'tb abide by all bMrms and conditions of this agreemerit,
induding Suilding Division Policy, which is incorporated herein by reference.
3, All conditions and requirements listed in tie attadied document entrfled "Requirements for 30 Day
Power for Testing" Iiave'been fulfilled and the premise is ready for compliance inspection;
4_ All requests for art extension beyond 30 days must be -made in writing to the Building & dal stating
the reason for the request. Power maybe removed- from the site and/ar a Stop Work Order Issued if
the rFinai'Inspection has not been approved within 30 days. A fee of $100.00 will be required to lift
the Stop Work. Order.
WE HEREBY RELEASE AND AGREE. TO HOLD HARMLESS, ST LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND .CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THI$ TRANSACTION, INCLUDING ANY DAMAGE'V HIC,H MAY BE INCURRED DUE To THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION Or- THIS AGREEMENT
OWNER SIGVATUM
DATE
UAlt.
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