HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE 2-21-1877
1� Planning & Development Services
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�B^nupi�lding & Code Regulation Division
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Fort Pierce, FL 34982
772-462-2165 Fax 772-462-
6443
Date:
Request for 30-Day Temporary Power Release
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" ---- Permit Number: / 7/0 — 7Z
Project Address: ; �—
RECEIVED
FEB 21 2010
Permitting Department -
St. Lucle Count,
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 TESTING
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATI
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS: ON OF APPROVAL SYSTEMS HE
1. This temporary power release is requested for the above stated purpose only, and there will be no
occupancy of any type, other than that y
Z. As witness by our signatures, we hereby agree to abide by alltter s and conditionlon during this time s 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 Testing" have been fulfilled and the premise is ready For compliance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order issued IF
the Final Inspection has not been a
the Stop Work Order. 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 POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT
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OWNER IGN a r�) , , u
DATE (,
;EN L SIGNATURE j
DATE
CTRICAL CONTRACTOR SIGNATURE C7`�i �/ , a i , ) a
DATE
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