HomeMy WebLinkAbout30 Day Temporary Power ReleaseJ
Planning,:& Development Services
Buildin & Code Regulation Division
Building 1 Regulation
2300 Virginia. Ave
Fort Pierce, FL34982
771-462-2,165 Fax 772;-462-6443
Request for 30-Day Temporary Power Release
Date: 5-30-1 T. Permit Number: SLCI 6060432'
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Project Address: 3050 NW Rack iffe. Way, Palm City, FL 349.90
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE. DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THI.RTY(30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FORA FINAL. INSPECTION. IN CONSIDERATION OF:A PPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGEA NVAGREE AS' FOLLOWS:
1. This temporary power release is requested, for the above stated purpose only, and there Will be no
occupancy of any type, other thah'thatpermitted by construction during this time period:
2. As witness by our signatures, we. hereby agree to abide by all terms and conditions of this agreement,
including Building: Divisioh:Pblicy,-which is 1 . hcorporated herein by reference.
3. All conditions and requitements-'litted in the attached -document entitled "Requirements for 30 Day
Power for Testing" have. bdm f0i lled and the premise is ready for compliance inspection.
4.All requests for an extension bqyond.30:.days must be .0aftle. 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. required. to lift
the Stop Work Order,
WE HEREBY RELEASE AND AGREE TO HOLD 'HARMLESS, ST, LUCIE I 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 THEE'VEN'T OF VIOLATION OF THIS AGREEMENT.
GENERAL CONTRACTOR SIGNATURE DATE
SIGNATURE