HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE19 09:11 FROM-
7723787656 T-570 P0001/0001 F-913
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772-462L- FaX 772-462-6443
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Perifit Nomber \2 V\
1
UNDERSIGNED HEREBY PEQUEgr RELEASE OF ELEL7111 . CAL POWER TO THE ABOVE DESCRIBED
)ERTY, FOR A PERIOD NOT To EXCEED THIRTY (30) DAYS, FOR THE PLW.'bSE OF -TESTING SYSTEMS
EQUIPMENT` IN PREPARA-110N FOR AlbiALANSPEL710N. INCONSIDERATION OFAPPROVAL OFTHE
JEST' WE -HEREBY ACkNOWLEDGE AND AGREE AS FOLLOWS:
I. TnIs temporary power release Is r0queftd lbr the above stated WPose only, and tiere wffl be no
occupancy of any o type, . other than that germitbad by construction during this tirrliB period,
2. As witrew by our $lgrottffes, We: hereby agrpp to abide by all telft and conditions of this agreement,
incitid1h; Building mAgion pbucv, vdjidh is incorporated heWn by reference.
3. All cordtions.and reVriemerft 95W in Me attedzed document ehtMed "Requhemerftjbr 30
Power forTesting" ham b$en fUlfilled'eind the pmrn! e " Day
s is ready for compliance inspecijon.
4.
All requesW for On 6darmflon beyond 30 days,inutt be tirade in wriahi; to the Ekulding Official
the rdL$on fbr Me re staring
, quest POW& MiY be larrIvAd, from the She and/or a Stop Work 0
the rinal'DWeedon has not bien ap . rder Issuo If
the Sbop Work Orden PMV0dVVlthlfn30'days. Akeof$jo . 0.00�vdii be required to Wt
HERESY RELEASE AND AGREE To HOLD HARMLESS, ST, LUqE (AUNTY,
LIABUrIES AND CLAIMS . OF ANY TYPE OFNN�k WHICH' MAY AR AND THEIR EMPLOYEES pROM
. ARISE NOW OR IN THE FUTM OUT
M. TRANSACT1014, TNCLUpMG ANy PAMAj3E BE IN, UftiEMWE TO THE
=kIsdriCiN OF ELEC*jCEP6W� IM THE 'E%0&OFVl0LAWN OF:Tms AsREEmuc.
1�.
DATE
DA'M
DATE'
rl, E
Rrgma . I
MAY 3
gerniitting Department
St. Lucie COunty, FL
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