HomeMy WebLinkAbout30 Day Power ReleaseST. LC.ICIE �-
Cou
Planning and Development Services
Building and Code Regulations
2300 Virginia Avenue
Fort Pierce, FL 34983
772-462-1553
Fax 772-462-6443
TEMPORARY EARLY POWER RELEASE
(Name of Tenant or Owner)
The Tenant or Owner requests St Lucie County Development Services Department to release the
electrical power at 5'105 �y,,,Q,�- �A,_r , (address, including suite number,
as posted on the electric meter and the building) for building permit oS _ Oy�—T , for the
purpose of construction and testing building systems, including air conditioning, refrigeration,
lighting, power and control circuits with the following stipulations:
1. Incomplete or untested circuits are NOT to be energized without properly licensed electrical
personnel on the jobsite and no systems are to remain energized beyond the testing/temporary
purpose without proper inspection by the St Lucie County Building Department appropriately
licensed person(s).
2. All panels and disconnects not in use must be locked in the "OFF" position or fuses removed.
3. Proper procedures for lockout/tagout must be in place.
4. The electrical equipment room (where applicable) will remain locked at all times with the key in
the possession of the electrical contractor.
5. All final inspections relative to the closeout of this project must be requested and passed in a
timely manner as determined by the Electrical Inspector and/or the Building Official.
6. The building may not be occupied before a Certificate of Occupancy (C.O.) is issued.
7. No stocking of materials, other than those required for construction is permitted by this agreement
8. No on -site occupancy or training of personnel employed by the occupant, business entity or owner
is permitted by this agreement
9. No furniture, racks, furnishings or other personal or corporate property is permitted on site by this
agreement.
10. Construction power remains covered by the requirements for GFCI protection and all other
requirements of the governing Codes, see National Electrical Code (NEC) Article 590.
Violation of this agreement may result in the immediate termination of the electrical power without
prior notice or warning to the affected parties. This form requires all of the following signatures
prior to power being released. The undersigned acknowledge that the operation of air conditioning
equipment while construction is in progress may create or increase the risk of contamination or
premature failure of the equipment.
The undersigned acknowledges the above listed stipulations, agrees to the terms of this agreement
and agrees to hold St Lucie County harmless from any damages that may arise as a result of the
release of power to the premises. The undersigned hereby requests power to be released for this
project. This form does not guarantee power, which is at the discretion and control of the electrical
utility.
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Important: The occupant of the property (a►• ()tiler appropriate Part ,
application to the electric utility, paid any applicable fees or ciepositsyand�rcqucstedlpo wcacle r in a
timely and Informed mallllcr. St Lucie Collllty Is Ilot 1•CSpOI1Slb]e t01' £illy delays 111 the receipt of
electric power, p
We acknowledge and accept the tel'1115 Of t]lIS l)CI'1I11SSlol1. We flll't]ICl' aCICnOWICCIge that VIO]ah01]
of this agreement or a findino
of unsafe conclitions and/or practices found on the site or occupancy
ot• the site may result in immediate disconnection of this tClllpO!'al"y l)ObVel" Wit]1011t bval•I1111g fiI1C]
herebywtirelease St Lucie County and all representatives of any and all liability resulting tiom us not
ablCllllg with this agreement.
Print Name/- Electrical Conti actor Company Name
• 0 IS191etl Or. 0 S,
gbha At. OAK 12/8/2021
Signaft rc - Electri al Contractor Datc
SIgIQiaturc
Date
Print Name - Electrical Contractor tics Gl a,,-�
Print Name - Eviler
( -1'12--) S__a S- a I �
1110110 Number - )✓Iv_ �ctrical Coll trtictur
Mr 12 0 0 1 .2'-1
License # Electrical Co 1 ractor
3-lS•2z
'ontrI<'I re -Prim
acto►• Date
Print Name - Pl'1111c Contactor
C-GC- I S a-r 3 l
License #!'rime Contractor
Approval 1'01- St. Lucie County by:
C12-2) SLe� - 8LfQ0
Phone Number -
Print Name - Prinle Contractor Company Name
(12.-1--) 3 3l, _- -1 S 3
Phonc Number - Prinlc Contractor
Signature - Electrical Inspector/BOInsp a
Inspector comments, limitations and restrictiolls: ID { Date