HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEREQUEST FOR 30 DAY TEMPORARY POWER RELEASE
DATE:
5-2-)-03
PERMIT NUMBER:
.11
PROPERTY ADDRESS:
2�lys vJ. �owc��( rt�. F-r. ➢1���, �`
ST. LUCIE COUNTY ING
UU VIRGIl\ONAVE
FORT PIER 34952-5652
Ph+.F561) 462 2165
FAX (561) 462-1148
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICALOEXCEED PTHIRER ( O
THE ABOVE DESCRIBED PROPERTY F ,'�F STING PERIOD
S ySTEMS TO
EQUIPMENT IN
DAYS, FOR THE PURPOSE O
PREPARATION FOR FINAL INSPECTION. IN CONSIDERATIONS OF OARS VAL OF
THE REQUEST WE HEREBY ACKNOWLEDGE AND AGREEA
power release in requested for the above stated purpose only,
1. This temporary 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 thehavecbeen fulfihed mlled andent tthe
"Requirements for 30 Day Power for Testing"
premises is ready for compliance inspection.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, S OF CCIE CTOUNTY9
YPE OF
AND THEIR EMPLOYEES AROIS ALL
LIABILITIES
R IN THE FUTURE OUT OF THIS
NATURE WHICH MAYBE
TRANSACTION, INCLUDING ANY DAMAGES WHICH MAYENT OF VIOLATION TIF
THE DISCONNECTION OF ELECTRICAL POWER IN THE
THIS AGREEMENT- /1i_ 4, n () n ,
lv) I i- VfL
OWNER
GENERAL CONTRACTOR
sf� If(' ;
ELECTRICAL CONTRACTOR
SIGNATURE