HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEW.
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2500,Vjfthiti Ave
FOX771461-6443
RECEIVED
MAR. 2 9 7018
Permitting Department
St. Lucie County
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Date:
1�) (,C - , 2�,,q
Pwhlk Wim. ber; C�
PrcjectA,ddress.
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL OMER TO T�� ABOVE DrSCRISE0
PRO
F
,Ty, FOR A PERIOD NOT`fO, E F. XCE8D 'THIRTY (30),DAYS, FOR THE PURPOSE OFtESIING SYSTEMS
ANb EQUIPMENT IN PREPARAnON 'FOR A FINAL.INSPE M-ON. 'IN CONSIDERATION OF APPROVAL OF THE
UQUEST WE- HE UBY ACKNOWLM�E AND AGRtE'AS MLLOWS.-
I. 7hJS temporary power reltase is fgqugsted tr the above stated purpoia only, and there will be no
oempancy of any type, Other than that permitbad by cahstrucidon during this time period.
2. As witness by our signatures, we her0by agree UD Wide by -all terms and conditions of this agreemerit,
includit Building DN191on -Policy, which is incorporaW h&ein by r�renca.
3. All conditions and requirerridnts• llst in the attadied document entffled'aRequirements for 30 Day
Pow& for Tesftgff hWe,bean fulffiled'aifid the premise is ready for compliance inspection. .
4. All ri 4ueft fbran• edension beyond 30 days -must be:rnade in writing to the Building Official -sMng
the reason for thit ra4uest, Power maybe Mrb0Ved-Trdm •the slLe and/br a Stop Work,'Cirder issued If
the Fla:Inspecti6n has riot betn approved within 30 days. A fee of $100.60 will be recibinbd to lift
the Stop Work Order.
VVE HMSY RELEASE AND AGREE TO HOLD KARMLESS S7. WCIE COUNTY, AND THEIR EMPLOYM FROM
ALL LIA13111TIM AND CLAIMS -OF ANY TYPE. or, �_A WHI6 KAY ARISE -NOW 0 R IN TH E. FUTURE OUT
OF THISTRANSACTIQN, INCLU "' k�W,
DINC ANY 0A -04C�IAAY PE INWR-ED.'DUE TO THE
DISCONNECTION OF ELECTRICAL P0'W'E*R IN THE EVENT OF VIOLATION Of THIS AGREEMENT.
IMM'SIGNATURE
DATE
668-1 LOW L000d 989-1 999L8L8ZLL _W0dj so: 0 L 8 L 1_6Z_80