HomeMy WebLinkAboutREQUEST FOR 30-DAY FOR TEM POWERFrom: 04/22/2022 06:20 #591 P.001/001
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Planning & evel opment Sermices
Building € .Code Regulation Division
2300 Virgin! Ave
Fort Pierce, ! 34982
772-462-21S Fax 7/2-462K644
1 Request ' g for 30-Da T
Date: J `71 7-2 F
Rsc;eci Address: 1,9�, ���
THE UNDERSIGNED HEREBY REQUEST RELEASE OF I
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY
AND EQUIPMENT IN PREPARA T ION FOR A FINAL INS
REQUEST WE HEREBY ACnNOWLEDGE AND AGREE A
1. This temporary power release is requested for
occupancy of any type, either than that permitt
2. As witness by our signatures, v-x_ hereby agree
including Building Division Policy, ,which is incoi
3. All conditions and requirements listed in the ad
Power for Testing" have been fulfilled and the 1
4_ All requests for an extension beyond 30 days n
file reason for the request. Power may be rem
the Final Inspection has not been approved twit
the SLop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMI
ALL IiABILITIES AND CLAIMS OF ANY TYPE OF NA'
OF THIS TRANSACTION, INCLUDING ANY PMAGE
DISCONNECTION OF ELECTRICAL POWEPyIN THE I
j
Ori1NFR SIGNATURE
SIGNATURE
RE
porary Power Release
slit Number' � zQ Iz, _O 4q I
-rra-i I
zCTRICAL POWER TO THE ABOVE DESCRIBED
0! DAYS, FOR THE PURPOSE OF T EST N!G SYSTEMS
:1,:TION. INCONSIDERA T IONI OF APPROVAL OF THE
FOLLOWS:
above stated purpose oniV, and. t eie will be no
by construction during this time p nod.
abide by all terms and condmons of th.s alpreemrnt.
rated herein by reference.
led document en tided "Requirements for 30 Dav
mice is ready for compliance inspection.
t be made in writing to the Building Official stating
ad from the site and/or a Stop Woik Order issued if
30 days A fee of s100.00 ob'ill be required to lift
ST. LUCIE COUNTY, ,AND THEIR EMPLOYEES FROM
WHICH MAY ARISE NOW OR !N THE FUTURE OUT
:H MAY BE INCURRED DUE TO THE
OF VIOLATION. OF THIS AGREEMENT.
DAIE
4/19/22
DATE
DATE