HomeMy WebLinkAbout30 day power release i
RECEIVED
APR 0 6 2022
Planning & Development Services
h l St.Lucie County
_ Building &ICode Regulation Division P"tt�n9
2300 Virginia Ave
• Fort Pierce, FL 34982
772-462-2165 Fax 772-46 2-6443
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Request for 30-Day Temporary Power IRelease j
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Date, q=�'a = Permit Number;
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Project Address: ��._ --
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THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO TiHE ABOVE IJESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSID_RATION OF APPROVAL OF: THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS: i
! This ternNraiy power release is requested to; the above stated purpose only, and there 4liil be no
orcupanc�-of any type, other than that permitted by construction during this nme period.
2. As M� ness try our signatures, we hereby a;ree to abide by all term, and conditions of thi;iagreement,
including BuikJing Division Policy, which is incorporated herein by reference. ,
3. t,)i conditions and requirements listed in the attached document entit!aj"Reguirernents for;30 Day
Power for Tc-stiny"have been fulfilled and the premise is ready for comp!iance inspection. ,
q. All requests for an extension beyond 30 days must be made in v,nting to theiBwlding Official 5t,361�y
the reason f:,c the request. Powerroar be removed From. the site.andio- a 5tc� Work Orde;i issued if
the Final Inspection has not been approved within 30 days. A fee of 3100 111.) will be required to!eft
the Stop n+:ack Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNI'f, 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
'VNER SIGNATURE DATE - — i ----- ---
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GENERAL C&JRACTOR SIGNATURE DATE I, V
ELECTRICAL CONTRA+C`i0R SIGNATURE DATE I
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