HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE02-06-'19 14:53 FROM-
7728787656 T-066 P0002/0005 F-079
4.
RECEIVED
k4lnia Ave
'vu;
lercei;F. 34-98.2- FE9 067019
'Pax, 779-462-6443 I Perroilt, Dep�rtrnent ll St. Lucgie cou.t.
Requ'ek'for 30-0,
DAL-. Perot 'Nf1mber:.\SQA
ftlect Andress;
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECrRjr_AL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD 70
NOT- . EXCEED I PURPOSE OF TESTING SYSTEMS
�IRTY(W)DAY-sJORTHEP
ANb EQUIPMENT IN PREPARATION FOR A RNAL.INSPECTION. W CONS10tRATION OF APPROVAL OF THE
REQUEST We -HEREBY AMOWLEDGE AND A� AS FOLLOWS:
I. This tanporary power reldwe is requi
o=PancY of any "e, other than thz
2. As witness by our sigrg6tt We her.
lndudih.g Building Div ion Policy,
3. Ail conditons.and ftirerne= Power for Teofig-O'hNt,be6n'fulflued
4. PJI requests fbr.ah. eDt Ion beyond '
the, rep$ori for the request.. Power Me
the Final Insp6:tion has not blew app
thd Sbop Work Order. -
ted for the abom slued purpose only, and there wa be no
permitLed by boftsturtion during this time period.
apiee to abide by*all terms and conditions of this agreement
is incorp
orated porated havOh by reference.
i the attadied document entitled "'Requ"mem for 30 Day
id, the' premise is ready fbr compliance jnspeclJon.
days must b6made in writing to the * Building Offidal stating
be mmoWd-ftm the site and/or a- Stop Work Order issued if
ved within 30,day& A fee of $100.00 Will be required to lift
WE HEkEBY RELEASE AND AGREE TO HOLD HARMLFsS, S.T. WCTE COUNTY, AND THEM EMPLOYEES FROM
ALL LLAZILMES AND diims.or- ANY TYPE &-NATRE wHicH mAy AR.-TS.E Now. OR IN
.1 . THE. FUTURE OUT
TRMSA C. W-HIQH MAY - DUE TO THE
OF THIS 1719N, JNC(Uq�M5 ANY IYAMAGE' Y BE
DISCOMECTION'OF ELECT-MCAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
DATE