HomeMy WebLinkAbout30 temp powerPlanning & Development Services
Building & Code Regulation Division
2340 Virginia Ave
Fort Pierce, FL 34982
772-462--2165 Fax 772-462-6443
Request for 30-Day Ternpurary Power Release
Date, 1 1
PrU•eCt Address;
PErril 2— M
THE UNDERSIGNED HEREBe REQUEST RELEASE G= EI.E-iPf(A rO,+;w� TO 7r= AyDVE
PROPERTY, FOR A PERIOD NOT TO EYC4fd THIFT•( (30) AVS, F(jP THE �UgPC};E OF "_STi?�G SrSTEMS
AND E QUIPMENT I PREPARA71ON FOR A fi I rfA, I rdS'DE T'a~% ",' f,-•,.. - C,; r A-7 is .,.
REQLIES'r VNE HER; -BY A001OWLEDGE AND i4;?F_E AS ^ri_LO-v%S
1 Thin Ce► pota-y po'fleI relea 5__ li It'glIA! Sypd ff, V)e'1riIt 5'XtF ;"'xP� vi- ct " ar ? ti.�'�
orcuparc} of an f type, other Mafi [hilt per,ni ael G:i +. nsrr . + r.- ,• tr" t me pc'-'U"
2 As voilmess Uy Our sign 1!was, ire r,oret4 1'1i1: Cc, a04Je E+r aTl of-i; a-,' turVi: 7'S of !q 3 nr'� YyrJZ_
if'cluding fiull nq 0!vmo* Poll y, vvhKh is Ir,.,orVFdted hete '- C, rr`P2•rrWe
3 41: tordlC,ar5 and lequlrenien'a lis[ied in the d3.te.r:?'J rlxurr•e' + er,r + t_j 'r:r r�r_Pd3 ry• ` a,
PDY.Per for f-silruj'' have ern 1041ed c'.0 rht ID F'p at- i5
4 Ali '&quests for a'i extension b?Yr,rVJ 30 ►I rs rn,6t LW_ rrrd{jF i rlr.• ._a •� .. C -��, r. fL•e�'
ll'' mason f'of th1're{iucic Power r^?'� to frrwv re 5P,E_ Cry.:.• } C.'i�' .'��`* i..7l. 57 __. ..
the Firial 1115PeC(lorl has no,, bpec. aVPr9VL-! ►v Curl? 30 dad; d feF
the Stop V.-Olp Dfde,.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ;T LUCIE .: 'a-r) T-if [a ci'a:_"yE; S F�:i
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATL1kE WHICH MA f ApjSE 'aC.'. GR I& THE ;�JTjR_ OJT
OF IMS TRANSACMCN, MCLUDING, ANY DA'4AGE WHICH PLAY HE U10,RPED Dir- r0 Tj=
DISCOtMECTION OF ELECTRICAL POWER M THE EVEtr OF VIOLATIOFI OF THIS AGREE-MEy-
NEE SIGUATUR:_ 6ATE
GE, l: ►SAL CONTRACTC)P. SIWOLIURE pA . C
ELECTRICAL CONTRACTOR 51jNAT0RE hA rE V-`��