HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE-jUANNEG
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Pian�nh g' : 6eii Qpment� aar-Oyes
StL Ki ing &' bde RegUiAti:on &i' i.sion
2366 Virginia Ave,
Fort Pieir!"De, FL 34992
772-462- 2163 Fax 772-462-f 443
Reciiiest4or 'kA i n= TeFnporary Power :Ret`ease
Date: �\ Permit Number:'""'`
Project Address:
THE UNDERSIGNED HEREBY REQUEST RELEIIASE 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 A kKAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUE!= 'VILE HSkEBY ACK'NOMEDGE AND AG tE AS FOLLOWS:
I. This temporary power release is requested for the above stated purpose only, and there va be no
occupancy of any type, other than that permitted by coast ctlon 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 lncomoraWd herein by reference.
3. All conditions and requirements listed In the attached document entitled "Requh-ements for 30 Day
Power fbr Testing" have been fulfilled ;and the premise is ready for compliance inspection.
4. Ali requests foran e#ension beyond 30 days must be.made in writing to the Building Of dai•stating
the reason for the requests 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 wilt be required to lift
the Stop work Order. I
WE HEREBY RELEASE AND AGREE. TO HOLD HARMLESS, ST. LUC%E COUNTY, AND THEIR EMPLOYS FROM
ALL LIABIlJTIES AND .CLAIMS OF ANY TYPE dF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAM, AGE'WHICH'MAY BE INCURRED DUE TO THE
DISCONNECifION OF ELECTRICAL POWER IN THE EVENT OF VJ0LAT1Oj4 OF THIS AGREEMENT
I
CONTRACI"OR
DATE ---
DATE
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