HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEaping & Development Services Department
Building & Code Regulations Division
2300 Virginia Avenue
Ft Pierce, FL 34982
Phone: 772- 462-2165
Fax: 772-462 2522
St. LUd8 CRequest for 30-Day Temporary Power Release
) 0 1 .Z47 Permit Number: 5 LC -
t Address:
UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
VE DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR
PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR FINAL
ECTION. IN CONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY
NOWLEDGE 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 Power for
4. Testing" have been faliilled and the premise is ready for compliance inspection.
5. 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.
HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
UR EMPLOYEES FROM ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
ICH MAY ARISE NOW OR IN THE FUTURE OUT OF THIS TRANSACTION, INCLUDING
( DAMAGE WHICH MAY BE INCURRED DUE TO THE DISCONNECTION OF
;CTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
SIGNATURE
Revised 06/14/2010
I d — 1-7—
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