HomeMy WebLinkAbout30-DAY POWER REQUEST FORM 2022-03-18 14:37 Wynne Buildoing Corp 7728787656 >> . P .1/2
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Planning .& Development Services
Building.& Code Regulation bivisi6n
2300 VI .Oinia Ave
Fort Pierce, FL 34982
772-462-2-165 . Fax 772.-462-6443
Request for 30-Day Temporary Power Release
Date: . _ .. Permit Number:
Project Address:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL DOWER TO THE ABOVE DESCZEED
PROPERTY FOR A PERIOD NOT I`0 FXCEED THIRTY(30) DAYS-, FOR THE PURPOSE OF TESTINC;SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A.FINAL.INSPECTION, IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE I-)M- 13Y ACKNOWLEDGE AND AGREE-AS FOLLOWS:
1. ?his temporary power release is requested for the above stated purpose only,anel there will be n0
ocai[vincy of any type,other titan ti)at permitted by construction during uiis time ppriod.
2. As w1trims by our signatures,we hereby agree to abide by all tenns and-conditions of this agreement,
In(lUding Building Division Polity,which is Incorporated herein by reference.
3. Ail conditions and requirements listed In tl'ic attached document enGtlCa-Requirements Tor 30 Day
Power for Testing'Have been fulfilled and the promise is ready for complianre inspection.
4. All requests for an extension beyond 30 days must be-made in writing to Use 13bilding Official stating
bie reason For the request. Power may be removed from the site and/or a Stop Work Order Issued if
the Final'Inspection.rias 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, S . 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 MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
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OWNER SIGN�A�LRr'"
GFNi=l2 .CONY 17rOR N Ri= DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE