HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEPlanning & Development Services Department
Building;& Code Regulations Division
SCANNED �2300 Virginia Avenue
Ft Pierce, FL 34982
BY phone: 772- 462-2165
St Lucie County , Fax: 772-462-2522
Request for
Date:
Project Address: 5393- 0441ex-d &-k
THE UNDERSIGNED HEREBY REQUEST REL.
ABOVE DESCRIBED PROPERTY, FOR A PERI
THE PURPOSE OF TESTING SYSTEMS AND E
INSPECTION. INCONSIDERATION OF APPRI
ACKNOWLEDGE AND AGREE AS FOLLOWS:
Temporary Power Release
Number: 10r- 00/51-
RF��!ED
o?019
0
'It CUde County ent
&SE OF ELECTRICAL POWER TO THE
D NOT TO EXCEED THIRTY (30) DAYS, FOR
UIPMENT IN PREPARATION FOR FINAL
,VAL OF THE REQUEST WE. HEREBY
1. This temporary power release is requested for 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 must be made in writing to the Building Official 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 $160.00 will be required, to lift the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
THEIR EMPLOYEES FROM ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
WHICH MAY ARISE NOW OR IN THE FUTURE OUT OF THIS TRANSACTION, INCLUDING
ANY DAMAGE WHICH MAY BE INCURRED DUE !TO THE DISCONNECTION OF
ELECTRICAL POWW IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
813112116
OWNER SIGNA II DATE
3
GE L CONTRACTOR SI NATURE ! ATE
3/2-1F
ELECTRICAL CONTRACTOR SIGNATURE DATE
r
SLCPDSD Revised 06/14/2010