HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEPlanning & Development Services Department
Building & Code Regulations Division
1 2300 Virginia Avenue RECEIVED
' - S f+/► p IA EI) I Ft Pierce, FL 34982
V�/CiN �'J Phone: 772- 462-2165 AUG 3 0 2018
Fax:772-462-2522
Permitting Department
equest for 30-Day Temporary Power Release St. Lucie Countv
Date: 3 / i� Permit Number: NLI - 01(2-
Project Address: S31V
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL 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 FINAL
INSPECTION. IN CONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY
ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested fo> the above stated purpose only, and there will be no occupancy
of any type, other than that permitted by construction during this time period.
2. As witness by our signatures, we hereby agree to abide by all terms' and conditions of this agreement, including
Building Division Policy, which is incorporated herein by reference.
3. All conditions and requirements listed in the attached document entitled "Requirements for 30 Day Power for
4. Testing" have been fulfilled- and the premise is ready for compliance inspection.
5. All requests for an extension beyond 30 days nnust be made in writing to the Building Official stating the reason
for the request. Power may be removed from Ithe site and/or a Stop Work Order'issued if the Final Inspection
has not been approved within 30 days. A fee of $100.00 will be required to lift the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HO
THEIR EMPLOYEES FROM ALL LIABILITI]
WHICH MAY ARISE NOW OR IN THE FUTU
ANY DAMAGE WHICH MAY BE INCURRED
ELECTRICAL POWER IN THE EVENT OF V
) HARMLESS, ST. LUCIE COUNTY, AND
AND CLAIMS OF ANY TYPE OF NATURE
E OUT OF THIS TRANSACTION, INCLUDING
UE TO THE DISCONNECTION OF.
ILATION OF THIS AGREEMENT.
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OWNER SIGNAT?�� D[AT!/Ey%7 (�///
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SIGNATURE
ELECTRICAL CONTRACTOR SIGNATURE
SLCPDSD Revised 06/14/2010
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