HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE10/31/2018 07:28 AM PDT
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TO:1V24621578 FROM:5616880909 Page: 1
=ANNEU
BY
S# Lude C011int,
Planning & Development Services R�
Building & Code Regulation Division'�D
2300 Virginia Ave ACT I7D1g
Fora: Pierce, FL 34982 Petmrtt,,,
772I-4�62-2165 Fax 772-462-644�3 St' �u � cut. n,
Request for 30-Day Temporary Power Release
Date; D 21 / 0 Permit Number; +Z cq6 � _ D 57 s
Project Address;. [A) AZ c o 21f 01
THE UNDERSIGNED HEREBY REQUEST RELEASE 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 FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
I. This temporary power release is i
occupancy of any type, other tha
2. As witness by our signatures, we
including Building Division Policy,
3. All conditions and requirements li
Power for Testing" have been ful'
4. All requests for an extension beyi
the reason for the request. Pow(
the Final Inspection has not beer
the Stop Work Order.
!quested for the above stated purpose only, and there will be no
, that permitted by construction during this time period,
iereby agree to abide by all terms and conditions of this agreement,
Nhich is incorporated herein by reference.
ted in the attached document entitled "Requirements for 30 Day
lied and the premise is ready for compliance inspection,
nd 30 days must be made in writing to the Building Official stating
may be removed from the site and/or a Stop Work Order issued If
approved within 30 days. A fee of $100.00 will be required to lift
WE HEREBY RELEASE AND AGREE 1*0 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 T NSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT Of VIOLATION OF THIS AGREEMENT,
OWNER
CONTRACTOR SIGNATURE
/y
DATE
DATE
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