HomeMy WebLinkAbout30 DAY REQUEST FOR TEMPORARY POWER RELEASEPlanning -& Devc
Building & Code
2300 Virginia AA
Fort Pierce, FL 3
772-462-2165
Request for 30-Day''Telm
Date: O% / o ��lt
Project Address:
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Permit
SCANNED
Selrvices BY
lation Division S$ Luele COMAY
Fax 772-462-6443
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Power Release
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THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTR CAL POWER TO THE ABOVE DESCRIBED:
PROPERTY, FOR A PERIOD NOT TO' EXCEED THIRTY (30) DAYS, -FOR THE PURPOSE• OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL,INSPECTI N. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE :AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the abc
occupancy of any type, other than that permitted by r
2. As witness by our signatures, we hereby agree'to abii
including Building. Division Policy; which is, incorporate
3. All conditions and requirements listed in the attached
Power for Testing" have been fulfilled and the premis
4. All requests for an extension beyond 30 days must be
the reason for the request. Power may be removed f
the Final Inspection has not been approved within 30
the Stop Work Order.
re stated purpose only, and there will be no
rnstrucdon during this time period.
a all ,terms and conditions of this
I; herein by reference.
locuftent.entitied,"Requirements for-30 Day
is ready for compliance inspection.
made in writing to the Building Official stating
om the site and/or a Stop Work -Order issued if
Jays. 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'C F VIOLATION OF THIS.AGREEMENT.
OWNER
GEN
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DATE
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