HomeMy WebLinkAbout30 DAY REQUEST TEMPORARY POWER RELEASE'Dows, E
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BU!Idlhg.*. Code Reg,11116t.lon M.Mon'.. -SCANNED.
2300 Vl�glnla'M6.
NUNTY B Y,
0 R I D A F0 ermi
it 01 FL 34.982. st. Lucie. (c.ra6nt' CD
772-462-2165'. fax-77246210
.6443..
701
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fbr 30-Day Timoorary Power, Releals'e"..
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dAddress: 31 SO- (6
JNDERSIGNED HEREBY REQUEST RELEASE OF, ELECTRICAL POWER TO THE'ABOVE DESCRIOED,
,ERTY,, FOR A PERIOD -NOT-TO. EXCEED tkIR1`Y.-(30):DAYS, FORTHE.. . PURPOSE OF TESTING -SYSTEMS.
P RATION' OF APPROVAL'OF THE
EQUIPMENT IN.PRE ARK17ION FOR A FINAL INSOJEC71ON, - IN CONSIDERATION
jWr WE HEREBY A'C'I(M'OV4'k"E''WE'AND-A'GR'EE AS FOLLOWS.
stated1. This temporary power release is requested for the above purpose only,,. and th will be no
er L
construction
during this time period.
2. All tovnjs *and &.016ns of this agree6ont
m including Building Division Palley, which is Incorporated r0f.n byrefeeence..
3. All conditions...............ted to the.attached documdnt entitled Vequirements for 30 Day
Pbwer'-tbrT*16g.!have bei!iifuMliedand-the 'prei��elseead.yfor'cotnpllb."ceinspecupn.
4. Al requests for an 6dinilopib'eyond.0ays rd6st.64madoinw%ritingtat e'Bulld'ln 11dal stating
the reason for the X0qdb9. Powet may. lie removed from ihi site and/di i fto Work Order issued If. -
the final Ihspedl:lofi.Mas not been approved Wthlh 30 days. of $100.00 "it 1*1equited to lift
...
the Stop Woi�ki bt&N'
IEREdY R'ELEASE.AND AGREE TO HARMLESS'- S-T..-tuqE.COUNTY--AN.D,THEIR EMPLOYEES FROM
L.M ,IABIES.ANt.)C-WM.S.O..FA..NY'-W' P.E.0 . F. NATURE WHICH
ICH MAY ARISE NOW OR IN THE FUTURE OUT'..
HIS TRANSACTION; INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE70 THE
owcrioisi OF. ELECMICAL,POWER IN THE. EVENT:bF VIOLATION OF.THIS AGREEMENT.
jqed
-3/5/2019
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O 'SMA DATETURE
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Do lugfgne� by:
3/6/2019
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4LWr&rGmgC0WMCT0K SIGNATUREDAT