HomeMy WebLinkAbout30 DAY REQUEST POWER RELEASE11/06/2009 17:02
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.RECEIVED
Planning .& Mvelopment Servim SEP o 5 Zola
Iftiidin g Ott We IIt"U1 l�lirt 1 on 0111 Permittin
23.00'�11rviniaAve st Luse epart ent
diet KO % FL 3498Z
COUntv
772-462-2165 FAX 7724 i-6443
Request for.30-Darr TewOorary lamer Release
tat: , - Pennt Number;
Prpject Addy
THE I NDEMG ED HERMY fkEQVEST lti= iron or t:i.ECi' CAL POWER TO THE ABOVE b6C SED
PROPER-tY, FOR A PERIOD NOT OT Tp EXCEED THIRTY (30) DAYS, FOR TtIE PURPOSE OF T. NG SYSTEMS
AND E001PMEW IN PREPARATION MPL A rT MLINSpECnON. IN CONSIDERA71ON OFAPPIROVAL Of THE
RE0.EIEST WE HEREBY ACKNOWLEDGE AND AGREE AS FO"WS;
I. This tempomry power release is requested for tits above ststed purPC*aonlV, and them Will be no
o=pahly of any tyAB, oil u than that perrnifte+d .by Cu*ruction dud% the Orate perlad.
2. As wkriess by our stgngtumos, we hereby agro tics abtda by all terms andomdmorls of this agreement,
indudirg Building Dlvlston Aollgt wtlith is lnmrporated "In by mfudim
3, AU Conditions anti mq*emer is llstad in #t athWl4d +lament ent Med "Racmirements 10r 30 Day
Power for Testing" have been fulbiied and the premise is ready for compilaMe Inspection.
e. All t for an e3rtensian beyr nd•34 must tag made in wfitirtg t{rthe Building Qfl .001 seat
the+ reasotl-for to reaam, Power may be removed from the site and/or a. Stop Work order issued it
the Final.Insp=on has not been approved within 30 days. A Me of $100.fl0 will tie required o lift
the Stop Work:Order. .
VM HAY RELEASE AND AGREE TO 14OLD HAiRMLESS, ST. 0= COtli Tyi AND THEIR EMPLOYEM FROM
ALL M'BILM E5 AND CLUMS OF ANY TYPE OF MATURE WWCH MAY ARISE NOW OR M TM FUTURE- OUT
ai" THIS 'i' NSACMtd, INCLIJIDING ANY DAMAQe 1NHM4 MAY OF INCURM DUE TO THE �
i3=NNI~CMN OF ELECTWCAL. POW#wR IN THE EVENT OF 1tIOLAITON OF THIS AGREEM Nt