HomeMy WebLinkAbout30 DAY TEMPORARY POWER REPLEASESt. Lucie County SCgNM
Building300 Virginia ADve ue partment Sit, t 4°fe oO
Fort Pierce, FL 34982 nt
772-462-2165
Fax 777-462-6443
Request for 30-Day Temporary Power Release
Date: A • t 3 • Ofj
Perraft.Nnmber: 0710 S - f")3(e O
Property Address: S" 11 c�2w 4v' + erS C l Lr :2,l ?C sr+ C 1 - L
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THE UNDERSIG"D HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
ABOVE DESCRIED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR
THE. PURPOSE dF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR FINAL
INSPECTION. ICONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY
ACKNOWLEDGEAND AGREE AS FOLLOWS:
1. This tem�orary power release is requested for the above stated purpose only,
and the will be no occupancy of any type, other than that permitted by construction
during th s time period.
2. As witav g by our signatures, we hereby agree to abide by all terms and conditions
of this ag eement, Including Building Division Policy, which is incorporated herein by reference.
3. All condf ions and requirements listed In the attached document entitled
"Require ents for 30 Day Pawer for Testing" have been fulfilled and the premise Is ready for compliance inspection.
4. All reqaE its for an extension beyond 30 days must be made in writing to the Building Official stating the reason
for the r quest. Power may be removed from the site and/or a Stop Work Order issued if the Final Inspection
has not een approved within 30 days. A fee of $100.00 will be required to lift the Stop Work Order.
WE HEREBY LEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
THEIR EMPLO ES FROM ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
WHI ISE NOW OR IN THE FUTURE OUT OF THIS TRANSACTION, INCLUDING
DAMAGE CH MAY BE INCURRED DUE TO THE DISCONNECTION OF
ELECTRICAL P IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
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CRACTOR SIGNATURE DATE
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