HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASESCANNEZ
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Q 140h1'09'& -6iVelopMent S.erwlices
B6.1din§ & -Ccde- jk '0 ation Division
2366Alrg'inia Ave
Fort � Pierce; Ki 349$2
772-462-*2i65 Faz 772-4G2-6443
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Reauestfor 30-Day Tensporalry mower- Release
Date: Permit WimberN ?�
1
Project Address: x
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THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECfRFCAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF`f'ESTING SYSTEMS
AND EWIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE'HEREBY ACKNOWLEDGE AND AGREE -AS FOLLOWS. -
I. Tiais temporary power release is requested for the above stated purpose only, and there wail be no
occupancy of any type, other than that permitted by construction during this time period.
2. As'witness by, our sign�Wres, we hereby agree to abide by ail terms and condiftons of this agreement,
induding Building Division .Pblicy, which is incorporated herein by reference.
3. All conditions and requirements lined in the attached document ended "Requirements for 30 Day
Power for Testing" have been fulfilled -and the premise isi ready for compliance inspection,
4. All requests for an. extension beyond 30 days must be made.in writing to the Building offcial stating
the 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 days. A fee of $100.00 will be required to lift
the Shop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEE'S* FROM
ALL LIAgILi ES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICti MAY BE INCURRED DUE TO THE
IDISCONNEMON OF ELEC, MCAL POWER IN THE EVEN' OF VICILAMN OF THIS AGREEMENT.
OWNER
5IGNATURE
DATE
908-J L000/ L000d 688-1 999L8LKLL -W da LO:O L KLZ-U