HomeMy WebLinkAbout30 DAY TEMPOREARY POWER RELEASEv80ANNED
..... �__. _.._....._.._ �_.. BY
��EE[iI19�B60 e�Fc jdDpflf�9elfdt Servicesf. L�udsCO�I� Y
Building & Code Reguyation
„ 2300 VirginiaAve Q�O�
Fort Pierce
FL 34982
_-._.............._....._-_•• 772-462-2265 Fax 772-462-6443
Request for 3O-Day TLMp®irary P01,'Ver Regease
Date:
Permit Number:
Project Address:
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:
1. This temporary power release is requested for the above stated purpose only, and there will be no
occupancy of any type, other than that permitted by construction during this time period.
2. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy, which is Incorporated herein by reference.
3. All conditions and requirements listed in the attached document entitled "Requirements for 30 Day
Ali requests for an extension beyond 30 days must be made in writing
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
4. to the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order issued if
the Final Inspection has not been approved within 30 days. A the Stop Work Order. fee of $100.00 will be required to lift
WE HEREBY RELEASE AND AGREE TO 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 FLfiURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
DWNE
CONTRACTOR SIGNATURE
-
DATE —'—'---
>? �� /T
DATE
DATE
NOV 2 9 2018
Permitting De
par 'rnent
St. Lucie
Count ,�, FL