HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEREQUEST FOR 30 DAY TEMPORARY PoWtR PUELEASE
DATE: ST. LUOIE COUNTY BLDG, & ZONING
5
2300 XgRGINIA AVE
PERMIT NUMBER: FORT PIERCE, FL 34952-5652
POSTED Ph. (561) 462.2165
_ FAX (561) 462-1148
PROPERTY ADDRESS: ---� ='
THE UNDERSIGNED HEREBY L'�IJAN
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TEE ABOVE DE REQUES'ItRRELEASE Ok',CTRZCAL POWER TO
SCRIBED PROPERTY, FORA PERIOD NOT TO EXCEED THIRTY (30)
DAYS, FOR THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN
PREPARATION FOR FINAL INSPECTION. IN CONSIDERAT16N OF .APPROVAL OF
THE REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
l, This temporary P ry power release in 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 i 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 Ifulfilled and the
premises is ready for compliance inspection.
WE HEREBY RELEASE AND AGREE TO MOLD HARMLESS; ST, LUCIE COUNTY,
AND THEIR EMPLOYEES FROM ALL LIARILITIE.S AND CLAIMS OF ANY TYPE OF
NATURE WHICH MAY ARISE' NOW OR IN THE E[TI' OUT OF THIS
TRANSAC`ITON, INCLUDING ANY DAMAGES WMCH MAY B�CURRED DVE TO
THE DISCONNECTION OF ELECTRICAL, POWER IN THE EVENT OF VIOLATION t )l;
THIS AGREEMENT. n
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GENERA,, CONTRACTOR SIG
CCU '-rc LL& co"'i
ELECTRIC.,AL CONTRACTOR SIGNATURE