HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASESCANNED
BY
RECEIVED
De,,elop
IRP
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T v 2300'�i�Rryin9a Ave Division Permitting Departmen,
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Fait Nerr-ce, FL 34982 St. Lucie Counr,
Request for 30-Day TLmpc;rarVPo
Date: Date: �GL Cr
Permit Number: 1 ��se
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Project Address: _2 `� (� S ..... --- Q _—
THE UNDERSIGNED HEREBY REQUEST- RELEASE OF ELECTRICAL POWER TO THE ABOVE
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF PPROV I
REQUEST' WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS: SYSTEMS
APPROVAI.OF THE
1, This temporary power release is requested for the above stated u
occupancy of any type, other than that permitted 6 Purpose only, and there will be no
2- As witness by our signatures, we hereby agree.to abide by all terms and conditions of this agreement,
y construction during this time period.
including Building Division Policy, which is Incorporated herein by reference.
3• All conditions and requirements listed in the attached document entitled "Requirements for 0Day
Power for Testing" have been fulfilled and the premise Is ready for compliance inspection.
4• All requests for an extension beyonc130 days Day
the reason for the request, power may y must be made in writing to the Building won.
the Final Inspection has not been a y be removed from the site and/or a Stop Official stating
the Stop Work Order. pproved'within 30 days. A fee of Work Order issued if
$100.00 will be required to lilt
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, Sf. LUCIE COUNTY
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARI
OF THIS TRANSACTIONTO THE
, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE AND HEIR EMPLOYEES FROM
DISCONNECTION OF ELECTRICAL POWER IN THE'EVENT OF VIOLATION S THIS OR IN THE FUR.iRE OUT
HIS AGREEMENT.
)WNER ,SIGN
DATE "
EN AL COtV7`RACTOR SIGNATURE
DATE
DATE