HomeMy WebLinkAbout30 DAY EMPORARY POWER RELEASEREQUEST FOR 30 DAY TEMPORARY .POWER RELEASE
DATE: St. Lucie County Comm. Devel. Dept.
Coale Compliance Division ;.
2300-.Virginia- Avenue
Fortz�Pierce, FL=3492-5652
i
PERMIT NUMBER:. - Ph.;(6 452=_2165 ` i
Fax 561) 462_1735
PROPERTY ADDRESS:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO
THE ABOVE DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30)
DAYS, FOR THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARA-
TION FOR FINAL. INSPECTION. IN CONSIDERATION OF APPROVAL OF THIS
REQUEST 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
premises is ready for compliance inspection.
We hereby -release and agree to hold harmless, St. Lucie County - and their employees
from all liabilities and claims of any type or nature which may arise now or in the future
out of this transaction, including any damages which may be incurred :due- to the
disconnection of electrical power in the event of violation of this agreement.- „
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Owner: Sig ature: j -
General Contractor: it Signature} i,