HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE/S
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REQUEST FOR 3,O DAY TEMPORARY POWER RELEASE
DATE: ? -? ^
PERMIT NUMBER:
PROPERTY ADDRESS:
THE UNDERSIGNED HEREBY
THE ABOVE DESCRIBED PROP
DAYS, FOR THE PURPOSE
PREPARATION FOR FINAL IN.;
THE REQUEST WE HEREBY A
1. This temporary power rel
and there will be no occui
construction during this tin
2. As witness by our signs
conditions of this agreeme
incorporated herein by refe
3. All conditions and regn
'Requirements for 30 Day
Premises is ready for comp!
WE HEREBY RELEASE AND A[
AND THEIR EWLOYEES FROM
NATURE WHICH MAY ARISI
TRANSACTION, INCLUDING AN
THE DISCONNECTION OF ELEC
THIS AGREEMENT.
C
OWNER
GENERAL CONTRACTOR
/ QCQPA 'TC CL..&Tf
ELECTMCAL CONTRACTO
%NNLUJ ST. LUCIE COUNTY BLDG. & ZONING
BY 2300 VIRGIN74 AVE
FORT PIERCE, FL 34952-5652
Ph. (561) 462-2165
POSTED ` FAX (561) 462-1148
f EB
,QUEST RELEASE OF ELECTRICAL POWER TO
'TY, FOR A PERIOD NOT TO EXCEED TWRTY (30)
F TESTING SYSTEMS AND - EQUIPMENT IN
,CTION. IN CONSIDERATION OF APPROVAL OF
2IOWLEDGE AND AGREE AS FOLLOWS:
ise in requested forthe above stated purpose only,
Bey of any type„ other than that permitted by
period.
Tres, we hereby agree to abide by all terms and
, including Building Division Policy, which is
ments listed in the attached document entitled
ewer for Testing" have been fulfilled and the
ce inspection.
ME TO BOLD �TARMLESS, ST. LUCIE COUNTY9
ALL LIABILTTIE$ AND CLAIMS OF ANY TYPE OF
NOW OR IN THE FUTURE OUT OF THIS
DAMAGES WFHCH MAY BE I'NCUMMD DUE TO
tICAL POWER IN THE EVENT' OF VIOLATION t )F
A71�71'�1tf1 UiIL
co"o
R SIGNATURE
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