HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEBCANNED
BY
M. iLude COUMV
S uoam Ong & C,(Pile Re ugadan
Fort PlerCPo'FL -34982
Request for _s) -B)riyVC'tlipr}aarf powev pow!..Reuease
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UNDERSIGNED H8REBY REQUEST'' RELEASE OF,ELEC T RICAL POWER` TO THE ABOVE bMtRI€3Eb
)ERTY, :FOR A PERIOD NOT TO EXCEED Tf-wTY po) DAYS, FOR THE PURPOSE;'GF T1' ST?Nf_ SYSTEMS
EQUIPMENT IN PREPARATION FOR A. FINAL INSPECTIOK IN CONSIbERA7TQN' f?F APPROVAL OF THE
JESTWE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOW$.$
1.. Ws.temporary power- release is requested, for the -aboye staied:puipose only,.: and,therewifl,be.no
occupancy of any type, oilier than that permitted by cons vcbbn 'during tFiiis `timne period.
Z. As wi Riess byour signatures,.we hi reby.agree fio abide by,. 0l1 terms and conditions of`this,a' reement,
including Building Division:Poiicy; which �s incorporaed,herein by deference.
3. -Ali condftibns-and requirements listed in the'atiached document entitled -Require -hints for30 Day,
Power forTesting"-have been fulfilled and.6e;premise; is ready for compliance iiaspe iibn:
4. .All: requests far an euiensibn, beyor d1b days nust,be made in writing io the 50dhjg.Official staying
the reason for the:request.. Power, may be removed from the site and/orz Stop Wort: Order issued if,
i iq Rnal`Inspec'don has riot been ,approved within 30 days. A free of $i0q 00 will be. required1b e&
the Stop Worle Order.
HEREBY RELEASE AND AGREE TO" HOLD HARMLESS, ST Lt1. .COUNTY,.AND THEER EMP40YEES 12ROM
LIABILI iTES.AND CLAIMS OF ANY TYPE OF 1$ATURE'WHICI MAY, ARISE NOW 'OR' IN THE FUT,d 1RE OUT
THIS TRANSACTION, INCLUDING. ANY DAMAGE'WHICH MA`I BE INCURRED`t DUE'T0. tHE
CONNECTION OF ELECTRICAL POWER INTHE EVENT O1= WOLAT ON'OF THI&ACREEMENT.
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