HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE6
LPlanning & Development Services
at.
Building & Code Regulation Division RECEMD
2300 Virginia Ave
Fort Pierce, FL 34982 MAR ®`$ 2819
772-462-2165 Fax 772-462-6443 Permitting Department
St. Lu
WNED
4a Request for 30-Day Temporary Power Release
-7L?4 Permit Number:
Address: —7tc(f 2P
Ie0I- NOZ8
TH UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PR PERTY, FOR A PERIOD NOT TO IXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AN EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
RE QUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
I1. This temporary power release is requested for the above stated purpose only, and there will be no
itoccupancy 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
II Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
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 Order issued if
the Final Inspection has not been approved within 30 days. A fee of $100.00 will be required to lift
the Stop Work Order.
WE EREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL P ABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OFT IS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
• ,j?IGNATURE DATE
-317
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�' !ISM • RSIG NATURE DATE