HomeMy WebLinkAbout30 Day Temporary Power Release--
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-216S Fax 772-462-6443
Request for 30-Day Temporary Power Releas �r
.. Date: g
Permit Number:,,_.. _ `l So' Z
Project Address: O 7 d �-
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THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL'POWER TO THE ABOVE
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS FOR PURPOSEFDESCRIBED
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION, SIN CONSID IOOF TESTING SYSTEMS
E
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:' RATION OF APPROVAL OF THE
1. This temporary power release is requested for the above stated purpose only, and there will be no
occupancy of any sign other than that permitted by construction during this time period.
including Building Division Policy, which i}
2. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
3. All conditions and requirements listed in the attached document entitled "Requirements for 0 Day
t,
s incorporated hereii by reference.
Power for Testing" have been fulfilled and the premise is read,; for compliance inspection:
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order issued if
the Final Inspection has not. been approved within 30 days. A, fee of $100.00 will be g
the Stop Work Order. required to lift
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE C.OU
1.
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHI NN' AND THEIR EMPLOYEES FROM
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATIONCH MAY. BE INCURRED DUE TO THE
THE FUTURE OUT
OF THIS AGREEMENT.
OWNER S RE
3ENERAL CONTRACTOR SIGNATURE
:LECTRI CONTRACTOR TLI
DATE
DATE
DATE