HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEPlanning &
SCANNED
BY
St Lu eRgRor
Date: V
Project Address:
elopment Services Department
& Code Regulations Division
2300 Virginia Avenue
Ft Pierce, Fl, 34982
Phone: 772- 462-2165
Fax:772-462-2522
Day Temporary Power Release
Permit Number: ! 9 0 K" 0-:�>4-:�7 0
bm(or- C>r
THE UNDERSIGNED HEREBY REQUEST RELY EASE 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 for the
of any type, other than that permitted by construc
2. As witness by our signatures, we hereby agree to
Building Division Policy, which is incorporated h�
3. All conditions and requirements listed in the attac
4. Testing" have been fulfilled and the premise is rei
5. All requests for an extension beyond 30 days must
for the request. Power may be removed from the
has not been approved within 30 days. A fee of $
WE HEREBY RELEASE AND AGREE TO HOLD
THEIR EMPLOYEES FROM ALL LIABILITIES i
WHICH MAY ARISE.NOW OR IN THE FUTURE
ANY DAMAGE WXICV MAY BE INCURRED
ELECTRICAL POWE14 IN THE EVENT OF V
OWNER
GENERAL
above stated purpose only, and there will be no occupancy
Lion during this time period.
bide by all terms and conditions of this agreement, including
rein by reference.
bed document entitled "Requirements for 30 Day Power for
dy for compliance inspection.
be made in writing to the Building Official stating the reason
site and/or a Stop Work Order issued if the Final Inspection
L00.00 will be required to lift the Stop Work Order. .
ARMLESS, ST. LUCIE COUNTY, AND
T) CLAIMS OF ANY TYPE OF NATURE
UT OF THIS TRANSACTION, INCLUDING
TO THE DISCONNECTION OF
TION OF THIS AGREEMENT.
L7/,/,() /9-0/
DATE
OCT 2 2019
17st
rmitting Department
SLCPDSD Revised 06/14/2010 . Lucie County, FL