HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEPlanni g & Development Services
0ulidi g a Code Regulation Division
2300 1rginia Ave
Fort Pl rce, FL 34982
772-4 2-21.65 -Fax 772-462-6443
Request for 30— Day emporary Power Release
Dale: 6
f Permit plumber: LC_ I q
Property Address:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED PROPERTY,
FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FQR THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENTS
IN PREPARATION FOR FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY
ACKNOWLEGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested
occupancy of any type, other than that pert
2. ' As withess.by our signatures, we hereby agi
Including Building Division Policy, which Is li
3. All conditions and requirements listed in th,
Power for Testing" have been fulfilled and t
4. All requests for an extension beyond 30 da)
the reason for the request. Power may be i
the Final inspection has not been approved
Stop Work Order,
fr the above state purpose only, and there will be no
Itted by construction during this time period.
ie to abide by all terms and conditions of this agreement,
;orporated herein by reference.
attached document entitled "Requirements for 30 Day
e premise Is ready for compliance Inspection.
must be made in writing to the Building Official stating
moved from the site and/or a Stop Worts Order Issued if
rithin 30 days. A fee of $100 will be required to lift the
WE HEREBY RELEASE AND AGREE TO HOLD HARM ESS, ST LUCIE COUNTY, AND THEIR EMPLOYEES FROM ALL
LIABILITIES AND CLAIMS OF ANY TYPE OF MATURE WHiCH MAY ARISE NOW OR IN THE FUTURE OUT OF THiS
TRANSACTION, INCLUDING ANY DAMAGE WHI H MAY BE INCURRED DUE TO THE DISCONNECTION
ELECTRICAL POWER IN THE EVENT OF VIOLATION qF THIS AGREEMENT.
SIGNATURE
rt,
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DATE .. -. _ .. --- -
1 _ I 16
DATE
RECEIVED SEP 0 7,2016