HomeMy WebLinkAbout30 day power releaseM. 1,U1
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Planning and Development) Services fi
Building and Code Regulations
2300 Virginia Avenue
Fort Pierce, FL 349813
772-462-1553 RECEIVED
Fax 772-462-6443i
! APR 0 6.2022
TEMPORARY EARLY POWER'"RELEASE
(Name of Tenant or Owner)
The Tenant or Owner requests St Lucie. County Development Services Departmelnt to release the
electrical power at a ,f�'Y1 , (address, including suite number,
as -posted on the electric meter anthe building) for building permit # ��05�0 \'gyp , for the
purpose of construction and testing building systems, including air conditioning, refrigeration,
lighting, power and control circuits with the following stipulations: '
1. 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. Construction 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 f air conditioning
equipment while construction is in progress may create or increase the risk of icontamination or
premature failure of the equipment. 1
The undersigned acknowledges the above listed stipulations, agrees,to the terms gof 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.
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ST. L End C 1VE
"Important: The occupant of the property (or other appropriate party) shall have made proper
application to the electric utility, paid any applicable fees or deposits, and requested power in a
timely and informed manner. St Lucie County is not responsible for any delays in the receipt of
electric power.
We acknowledge and accept the terms of this, permission. We further acknowledge that violation
of this agreement or a finding of unsafe conditions and/or practices found on the site or occupancy
of the site may result in immediate disconnection of this temporary power without warning and
hereby release St Lucie County and all representatives of any and all liability resulting from us not
abiding with this agreement.
w. We . �'V11iG�
Print Name - Electrical Contractor Company Name
,I l 6 / az �jl �l Z z
Signature -Electrical Contractor Date Signa re - Ow r Date
Print Name - Electrical Contractor Print Name - Owner
Phone Number - Electrical Contractor Phone Number - Owner
15C130094143
License# Electrical Contractor
y Signature - Prime Contractor Date
Print Name - Prime Contractor
CGC-- lS 116q°1
License # Prime Contractor
Approved for St. Lucie County by:
\►. >1 PJG LLB, .
Print Name - Prime Contractor Company Name
Phone Number - Prime Contractor
Signature - Electrical InspectorBO Insp ID # Date
Inspector comments, limitations and restrictions:
2