HomeMy WebLinkAbout30 Day Temporary Power ReleaseL l
Date: 4t1V6__
Project Address: 67 a S 5
Planning & Development Services Department
Building & Code Regulations Division
2300 V'uginia Avenue
Ft Pierce, FL 34982
Phone: 772- 461-2165
Fax: 772462-2522
Request for 30-Day Temporary Power Release
ly10_OX-8
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
ABOVE DESCRIBED PROPERTY, FORA PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR
THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR FINAL
INSPECTION. IN CONSIDERATION OF -APPROVAL OF THE REQUEST WE HEREBY
ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporarypower release is requested for the above stated purpose only, and there will be no occupancy
of any type, other than that permitted by construction. during this time period.
2. As, witness by our signatures, we hereby agree to -abide by all terms and conditions of this agreement; including
Building Division Policy, which is incorporated herein by reference.
3. All conditions and requirements listed in the attached document entitled "Requirements: for 30 Day Power for
4. Testing" have been fulfilled and the p "remise is ready for compliance inspection.
5. All requests for an extension beyond 30 days must be made in writing to the Building Official stating the reason
for the request Power maybe removed "from the site and/or. a. Stop Work.Order issued if the Final Inspection
has not been approved within30 days. A fee of $100 00 will be required to lift"the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
THEIR EMPLOYEES FROM ALLLIABILITIES 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..
Z—Z7—IS
GNATURE DATE
EN11�11ZSIGNATURE DATA
a r�
SLUDSD Revised 06114t2010 R E APR 6? 2015
����VED t.