HomeMy WebLinkAbout30 Day Request Temporary Power RelaseRequest
Date: 1 /12/16
Project Address:
Planning & Development Services
uilding & Code Regulation Division
300 Virginia Ave
Drt Pierce, FL 34982 RECEI►,":D FEB 161016
72-462-216S Fax 772-462-6443
30-Day Temporary Power Release
Permit Number.
515Nettles Blvd, Jensen Beach, FL, 34957
THE UNDERSIGNED HEREBY REQUE
PROPERTY, FOR A PERIOD NOT TO
AND EQUIPMENT IN PREPARATION
REQUEST WE HEREBY ACKNOWLEE
1. This temporary power releas
occupancy of any type, other
2. As witness by our'signatures
including Building Division Pc
3. All conditions and requireme
Power for Testing" have bee
4. All requests for an extension
the reason for the request.
the Final Inspection has not
the Stop Work Order.
RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
-EED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
R A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
AND AGREE AS FOLLOWS:
is requested for the above stated purpose only, and there will be no
than that permitted by construction during this time period.
we hereby agree to abide by all terms and conditions of this agreement,
icy, which is incorporated herein by reference.
is listed in the attached document entitled "Requirements for 30 Day
fulfilled and the premise is ready for compliance inspection.
)eyond 30 days must be made in writing to the Building Official stating
ower may be removed from the site and/or a Stop Work Order. issued if
een approved within 30 days. A fee of $100.00 will be required to lift
WE HEREBY RELEASE AND AGREE To HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES 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 P WER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE ' DATE _
>1 (� �
GENERAL CONTRACTOR SIGNA DATE
ELECTRICAV CONTRACTOR SIGNATURE DATE
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