HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE2022-05-02 15:55
Wynne Building
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772-467-21
Resquest��for 30-Day
Date: � \� \�
Project Address:
.roie0'opltnent Services
16 K- Motion 61VI do
Avg
P Fax 772-462-6443
Power -Atlease
Number: -a\ZQ& `
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THE UNDERSIGNED HEREBY REQUEST RELEASE OF EL
PROPERTY, FOR. A PERIOD NOT TO EXCEED- THIRTY (;
AND EQUIPMENT IN' PREPARATION FOR A FINAL INSP.I
REQUEST WE H ACKNOWLEDGE AND AGREE AS
I. This temporary power release is requested for
occupancy of any type, Qther than that pernird
2. As witness by our signatures, we hereby agree
including Building Division Policy, which is incol
3. All conditions and raquir&hents IlstAd in thie ab
Power for Testing" tiave'been 'fulfiiled and the 1
4. All requests for an extension beyond 30 days n
the reason fbr the request. Power may be rern
the Finallnspeclfon he's not been approved wilt
the Stop Work Order. -
WE HEREBY RELEASE AND AGREE TO HOLD HARP
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF Nf
T OF TKS TRANSAC9 N, INCLUDING ANY DAMAGI
DISCONNECTION OF ELECTRCCAL POWER IN THE
RECEIVED
MAY Q 7 2022
at 11cie County, Permitting
TRICAL POWER TO THE ABOVE DESCRMED
DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
RON. IN CONSIDERATION OF APPROVAL OF THE
above stated purpose onty, and Mere vudl be no
�y cohstruction during this lima period.
abide by all terms and conditions of this agreement,
atted herein by reference.
ied document entitled "RegUlremenfs 1br 30 Day
nise Is ready for compliance Inspection.
be;made in writtno to the Building'Offidal stating
d'from.the site and/or a Stop Work Order Issued if
30 days. A fee of $100.00 will be required to lift
ST., LUCIE COUNTY, AND THEIR EMPLOYEES FWM
WHICH MAY ARISE NOW OR IN THE FUTURE OUT
:.H MAY BE INCURRED DUE TO THE
'OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNA'N DATE
G CONTRAC't'Ok RE DATE
GATE
ELECTRICAL CONTRACTOR SIGNATURE I