HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEPlanning & Development Services
Building & Code .Regulation Divis'o-n
2300 Virginia Ave
Fort Pierce FL 34982
772-462-216S Fax 772-462- � �,43 JA' ®2 : j?j
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Request for 30-Day Temporary Power Release
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� -yD l _ Permit Number:
7 S� �i��� I ff5erJo K 'PR is v MANNED
Address: QV
92 Luc.i county
TH UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PR6PERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION. FOR A FINAL INSPECTION. INCONSIDERATION OF APPROVAL OF THE
RE F,UEST WE HEREBY ACKNOWLEDGE 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 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 Inspection has not been approved within 30 days. A fee of $100.00 will be required to lift
the Stop Work Order.
WE 1:HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE. COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF���HIS TRANSACTION, INCLUDING ANY DAM GE WHICH MAY BE INCURRED DUE TO THE
DIS,'CONNECTION OF ELECTRICAL POWER IN THE'EVENT OF VIOLATION OF THIS AGREEMENT.
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Owl '' ER SIGNA DATE
GENERAL CONTRACTOR SIGNA DATE
02.
ELE I ONTRACTOR SIGNATURE DATE