HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEa- _
PQanitor g Devegopilnent serwces
t �Il�a��li� �;®�e➢aka®n Dow
Sion
0- Q synFort P,
k
Request for 30�Day ye>rtlnporary Po�ver ��9�a�� r;Sf�� . 01
� 1 e
Dace: _ z' CZA �®
-- Permit Number: _ �� "'
Oe
Pr
Ct Address: —J—
THE UNDERSIGNED HEREBY REQUEST- RELEASE OF EL-ECMICAL POWER TO THE ABOVE
PROPERTY, FOR A PERIOD NOT TO' EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTI
AND EQIJIRMEM IN PREPARATION FOR A:FINAL INSFEC7TON: IN CONSIDERATION OF DESCRIBED;
REQUEST U1IE HEREBY ACKNOWLEDGE AND AGREE.AS.FOLLOW' : NG'YSf EMS
APPROVAL OF THE
1, This temporary•power release is requested for the above stated purpose only, and'ther&will
occupancy of any, type, other than. that permitted by construction dWringahis time period, be no
2,. Acludi g it our signatures, we hereby agree to_abide by all,terms and conditions of this agree
Including 6uilding.Dlvlsion Policy, which,!s incorporated' herein by reference:
3: Po conditions and requirements listed.in the attached document entitled'."Requirements• for 30 Day
Power for Testing" have been fulafted.and'the premise is ready for compliance a irements, f
4: All requests for an extension beyond 30 dags.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 da s. .9
the Stop Work Order, y A fee oF. $109:00 wil! be: requlr Issued,
lilt'
WE HEREBY RELEASE AND. AGREE TO HOLD HARMLESS, Sf. LUCIE COUNTY, AND THEIR
ALL LIABIt_ITIES AND Cl AIMS.OF ANY TYPE OF NATURE WHICHMAY ARISE NOW OR OM
FUTURE OFTHIS=TRANSACTION, INCLUDING ANY DAMAGE iNHICH'MAY. BE INCURRED DUE TO THE
E FUTUR FROM
DISCONNECTION OF ELECTRICAL POWER IN THE,'EVE` - OF:VZOLAA7ION OF THIS.AGREEH E OUT
E
✓` ENT,
-----------------
DA
DATE