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Home My WebLink About30 DAY POWER RELEASEDocuSign Envelope ID: 6FC6BA38-5654-4D91-90D9-C30E33F5E778 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 D Z*n41-t 1 o_- Tenant-or Owner) The Tenant or Owner requests St Lucie County Development Services Department to release the electrical power at 50 9 M • H 3,:� --, , (address, including suite number, as posted on the electric meter and the building) for building permit # for the purpose of constntction and testing building systems, including air conditioning, refrigeration, lighting, power and control circuits with the following stipulations: I. 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. Constriction 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 constriction 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. DocuSign Envelope ID: 6FC6BA38-5654-4D91-901)9-C30E33F5E778 Important: The occupant of the property (or other appropriate u•t application to the electric utility, paid an p� Y) shall have made proper timely and infon»ed manner. St Lucie Cc Inty liis not responsibleees or in the ed Power cei t of electric power, p We acknowledge and accept the terms of this permission. We further acknowledge that violation Ofthls agreement or a finding of Unsafe Conditions and/or Practices found oil the Slte OI' OCCU anc of the site nlay result in immediate disconnection of this tern oy hereby release St Lucie County anrar p d all representatives of one and all iaowe resultLI( warning and abiding with tI11S a$feCnlCnt, y tom us not -IC-E -=�- G1-ccdv,'C1 Print Name - Electrical Contractor Company Name 1 •••—DocoSigned by: Si�matt re - Elecha•i Contractor p -&opr3aa9a2aa9ae�svner Datc Print Name -Electrical Co ntrltctor Phone Number - Glcetriv�ti► C0IIlL*Uclol. License 9 Electrical Contractor 3 _3 t2 . gnnture - P►•ime C'ontrat. r Uate .� o;� -A. C31-1-`.0--- Print Name - Prime C'nnh'actor C_6--c - 15 a�t�a3 l License # Prime Contractor Approved t'nr St. Lucie Counts• by: m til a — Print Nml e -Owner I'hone Number pwncr�, "ria zc.� B,t-t t ,i , .s Print Name - Prime Contractor C'omhany — - ('l��) 33u_- -1,-5 3 I'honc Number -Prime Contractor Si-(naturc - [:IccU icul Insiicctor BO Inspector cotluncnt5. limitations and re,t ictionsF' I[) Date