HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE\ ! SCANNED
BY
St Lug COD*
Planning & Develc
Building & Code R
2300 Virginia Ave
Fort Pleme, FL. 341
772462-2165 1
Request for 30-Day Tem
vent Services
uli ion Division
RECENED
772-462-6443
SEP _17 2t
' Pe St��u Lucie Coy
Power Release
Date: / Permit Nu ber:
Projcct Add ress: ?s���-lti f 01��'-' ) (All
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECT'RIC�L POWER TO THE ABOVE DESCRIBED -
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAY , FOR THE PURPOSE OF TESTING SYSTEMS
ANO EQUIPMENT IN PREPARATION FOR A, FINAL INSPECT1 T IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLO S:
1. This temporary power release is requested for the above tated purpose only, and there will be no
occupancy of any type, other than that permitted, by con�tructlon during this time period.
Z, As witness by our signatures, we hereby agree to abide any all terms ana conditions of this agreement,
including Building Division Policy, v4hich is incorporated hFein 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 isready- for compliance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
Lhe 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 approved within 30 da s. A fee of $100.00 will be required to lift
the Stop Work Order. �'
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LPCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILMES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARTSF NOW OR IN THE FUTURE OUT
OF THIS TRA ACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTYON OF ELECTRICAL POWER:IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OW IG TURE 7TE.:70
G F CO GTOR SIGNATURE DA E
ELMTRICAI CONTRACTOR SIGNATURE DATE
TO/TO 39dd :a'igwmmm 9Z69L69ZLL 6T:bT 8TOZ/LT/69