HomeMy WebLinkAbout30 DAY TEMPORARU POWER RELEASEu
SCANNED
BY
Plan-nihl � u 1opmen*_,vices
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-pay Temporary Poorer Release
Permit: Number: 1 G O'Sr 0 J rt 4
Address: 10fa►� i�r . Lo '-90, V:'i
40 dF C15-1
THE NDERSIGNED HEREBY REQUEST" RELEASE OF ELECTRICAL POWER TO T"E ABOVE DESCRIBED
PROP RTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND QUIPMENT IN PREPARATION FOR A FINAL INSPECTION, IN CONSIDERATIdN OF APPROVAL. OF THE
REQU ST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. Ibis 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 referenoe.
3. All conditions and requirements listed in the attached document entitled "Requirements for 30 Day
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 Inspction has not been approved within 30 days. A fee of $100.00 will be required to lift
the Stop Work Order.
WE HE BY RELEASE AND AGREE TO HOLE] HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM.
ALL ILMES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF TH TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCO NECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER 1IGNATURE bA
GEN CONTRACTOR SIGNATURE l"E
ELE L CONTRA OR SIGNATURE DATE
I
RECEIVED NOV 0 9.;2016