HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASERECEIV17D Nd 2015
Planning & Development Se , rvices _
- Building & Code Regulation DivistoN� n�
2300 Virginia Ave
° FoBY
rt Pierce, FL 34982
St. Lucie County
772-462-2165 Fax 772-462-6443
j Request for 30-Day Temporary Power Release
Date: 2
Permit Number: Fj7 S7
I. Project Address: -D7fj--
j 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'
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
SYSTEMS
REQUEST VJE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
APPROV
i
1. This temporary power release is requested for the above stated purpose only, and there will be
occupancy of any type, other than that permitted by construction during this time period. no
2. As witness by our signatures, we hereby agree to abide b I!
terms and
J including Building Division Policy, which is incorporated herein. by refer ncenditions of this agreement,
3. All conditions and requirements listed in the attached document entitled "Requirements for
Power for Testing" have been fulfilled and the premise is ready for compliance inspection. 30 Day
4. 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 Ord
.the Final Inspection has not been approved within 30 days. A fee of $100.00 will be r
the Stop Work Order. Order issued if
required to lift
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCI
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR I
OF THIS TRANSACTION, INCLUDING ANY DAMAG E COUNTY' AND THEIR EMPLOYEES FROM
DISCONNECTION OF ELECT CAL POWER IN THEE ENT OF IOBE LATION INCURRED DUE TOT THE
FUTURE OUT
OF THIS AGREEMENT.
0 NERIGN
DATE
GENERAL ON WCTOR SIGNATURE l
DATE
CONTRACTOR