HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASERECEIVED
I APR o 6 2022
Planning & Development Services St. Lucie County
Building & Conde Regulation Division potti9i fig
2300 Virgi!a Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
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Request for 30-Day Temporary Power Release
Date: 'C��a _ _ Permit Number: _ ( �= 4_L4 e
Project Address: Z�3C� i'L�^^ A�-_ Gr� ------ --- I
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THE UNDERSIGNED HEREBY REQUEST RELEASE.OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TES SING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSID_RATION OF APPROVAL OP THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temp>ra:y power release is requested fo; the above stated purpose on:y, and there tyil� be no
occupancy of any type_, other than that permitted by construction dunn3 this Mime period.
witness try our signatures, r;e hereby a;ree to abide by all term; and conditions of this al reament,
including Building Division Policy, whi_h is incorporated herein by reference.
3. 0 conditions and requirements listed in the attached document entit!6:1 "Req_iii ernents for .341 ;Tay
Power for TestinQ" have been fulfilled and the piernise is ready for complOncei inspection.
9, All requests foe an extension beyomd 30 d3y5 must be made to tinting to ttie gUilding Officialsta ing
if
the reason fx the request. Power may be removed from the site. ar+d/o, a Strip v'�OrK Order 15,Uctj
the Final Inspection has not beer, approved within 30 days. A fee of $100 0t) will be re
quired to 4 ft
the Stop Order.
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V-1E HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE CnUN Fr', AND (THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH'MAY ARISE NOW OR IN THE F I TUBE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCUPRED DUE TO THE �
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT
SIGNATURE
GENERAL CON7RAf_TOR SIGNATURE
ELECTRICAL CONTRACTOR SIGNATURE
DATE
-G -2-2.
�DAT;E
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