HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE05/23/2007 14:44 FAX IM003/003
�� St. Lucie County
uilding & Zoning Department
MAY 2 3 2007 2300 Virginia Avenue
Fort Pierce, FL 34982
Public Works 772-462-2165
St. L.uoie County, FL. Fax 772-462.6443
Request for 30-Day Temporary Power Release S 6 Z21
via —
Permit Numbers`g 1_.L -
Address: `" I /-,CD
UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
VE DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR
PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR FINAL
ECTION. IN CONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY
NOWLEDGE 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 Oftial stating the reason
for the request. Power may be removed from the site and/or a Stop Work Order issued if the Final Inspection
bus not been approved within 30 days. A fee of $100.00 will be required to lift the Stop Work Order.
HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
FIR EMPLOYEES FROM ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
ICH MAY ARISE NOW OR IN THE FUTURE OUT OF THIS TRANSACTION, INCLUDING
DAMAGE WHICH MAY BE INCURRED DUE TO THE DISCONNECTION OF
CTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT..
OWNER SIGNATURE V DATE
5- ;zJ
GENERAL N OR Sr DATE
G
ELE TRICAL CONTRACTOR SIGNATURE DA