HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEREQUEST30 DAY TEMPORARY P:.:KER RELEASE
DATE: ST. LUCIE COUNTY BLDG. do ZONING
_ .. ILI `57 2300 VIRGINIA AVE
PIERCE, FL 34952-5652
PERMIT NUMBER ' D Ph. (561) 462-2165
NVV 0aa2P§S FAX (561) 462-1148
PROPERTY ADDRESS:+Le_cis�li�t(1fG \poii� 3(
THE UNDERSIGNED E EREBV REQUEST RELEASE OF ELECTRICAL POWER TO
THE ABOVE DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED TBMTY (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
cunt uetion 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 refereoce.
3. All conditions and requirements listed in the attached document entitled
`Requirements for 30 Day Power for Testing° have been fulSlied 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
ryas AGREEMENT. rD ^ SCAmw
GENERAL CONTRACTOR SIGffAMT M
REQUEST FOR 30
DATE:
DAY TEMPORARY POWER RELEASE
ST. LUCIE COUNTY BLDG. & ZONING
PERMIT NUMBER: SCANNED
a BY
St Luc a County
PROPERTY ADDRESS:
2300 VIRGINIA AVE
FORT PIERCE, FL 34952-5652
I OCT 0 3 2005
Let WCIe County Public ilVo(i:9�
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL
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:
L 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 witness by our signatures, we hereby agree to abide by all terms and
conditions of this agreement, including Budding 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 fulfdled 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 i )F
TE IS AGREEMENT.
GENERAL
Caj
ELECTRICAL CONTRACTOR SIGNATURE