HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEREQUEST FOR 30 DAY TEMPORARY POWER RELEASE
DATE: �\�\05 I. LUCIE COUNTBLDG. & ZONING
Y
VIRGINIA AVE
4 _ FORT PIERCE, FL 34952-5652
PERMIT NUMBER: Ph. (561) 462-2165
2-4 0 ( f Z 5-5— FAX (561) 462-1148
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PROPERTY ADDRESS. APR' 4 ZOOS MCA�� � ,
—� BY-
\'L2- 1Y. ti 5 ` 5: •��.k : luCle County Publ ic BY .'
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_ 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
PREPARATION FOR FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF
THE REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release in 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 i'vitness 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 OF
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.
SIGNATURE
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ELECTRICAL CONTRACTOR ' SIGNATURE