HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE12-' 19 15:32 FROM- 7728787656 _, T-636 P0001 /0001 F-018
Y
....... . Lucie (oupity IFU7 - 0
Bd
ton
y 2300• � Va
in *Ye
Not,
Fax -772-461-6443
Uri f*0 30-0 -7-0m, i1try-ft or -Re 5e
Addre= 'RS \
UNDMLSIGNED HE BY REQUEST RELEASE OF ELECTRICAL POWER TO THE ADM DESCiMM
'aM, FOR A• PERIOD KOT TO EKMD" THIRTY (30) •PAYS, FOR, THE PURPOSE OFTES'TING SYSMMS
E4ZUlPMENT IN •PREPARATION FC)R A fM F LL INSPECTION. IN CONSMaa ATION- OF APPROVAL OF THE
VtT WE•Mi Y A*ZWLENMAND AGAIEE'AS OM:
I. 7 his bm4mry Pmmer
r9lem is r�tyuesMd for above meted
occupancy of an �'' �+, and ti � 'tie rt<'i
Y tIps, Ate' than that Permitted by ,coT traction 'dUrirtg this timt pendd.
2. As w75ri 'toss by Our signdtut� v*- hereby-4gree to Oldg, by-a1f terms and eon ftorts of MS agreemerity
includiii. EUlding Division Policy, Which is incorpomt'ed hewn by rderenc e.
3. AM cortdltiiins.and requiremerts, fis i' in the att0thed document .MMed "lequiremenis for 30 Day
Power for'T'esting" T 'beUm, fulfged'and the prernise is ready for c omprance inspecGon.
4. ATl'req'uesh- foram adension beyond 30 days must b&made in writing to the Building Official siating
the reWn for the request, •Pdw8r may be rc moVed1rom the site and/or a Work• Order issued if
the girt Inspection has not been approved within 30 days, A fee of $100.aa will be required to lift
the Stop Work Order.
HEREBY RELEASE ,AND AGREE TO HOLD JfARML ESS, .Si". LUQE COUNTY, AND TH€ER EMPLOYEMPLOYEZS FROM
i,TA6'T(1 RES AND aTM OF ANY TYPE, O laiAT J1 E Vr H10i MAY ARISE NOW OR IN THE FtiT M OUT
TRA'I MMON, II�Ct�UDM1 AW DAM1Ar� CW,• 4AY k iNL`E R— ' DUF TO 7HE
ii� N Oi=1� & RiC.AL TIER 1N THE 66 OF MiANON OF THIS AME EM