440 Court Street Clearwater, FL 33756 building@pinellascounty.org 727-464-3886 727-464-3888
Revised 2/26/2013
Commercial Temporary Power
Application & Agreement
Date
Permit#
Project Name
Project Address
Applicants Statement:
In consideration for authorizing the appropriate utility company to energize the facility; we agree to and understand the
following:
1. Temporary Power fees must be paid prior to release of Temporary Power.
2. I/We will have the appropriate Fire Authority approve this application prior to submission.
3. Temporary Power is to be used only for the purpose(s) identified below and I understand that I/We are responsible to
not allow any person or sub-contractor to violate this agreement or to use power in a hazardous or unauthorized
manner.
4. I/We understand that this approval for Temporary Power is for a maximum of 30 days. Extensions of time will require
re-application and additional fees.
5. I/We understand that if the building is occupied before a certificate of occupancy has been issued or any portion of this
agreement is violated that the Building Official will have the right to direct the utility to terminate electrical service
without notice. Furthermore, I/We understand and agree that should the Building Official exercise such right, Pinellas
County BDRS will not be responsible for any damage or cost which may result from the exercise of such right. Also, in
the event any third party claims damage from the exercise of such right, I/We agree to jointly and individually indemnify
and hold harmless the Pinellas County BDRS from all such damages and cost, including attorney’s fees.
6. I/We will lock off access to uncompleted areas and/or lock off service to areas where exposed wiring has not been
completed.
Interior Lighting Purposes. (Where the length of extension cords exceeds 500 feet)
Testing of Air Conditioning Equipment-Excluding window units (Approved Final Mechanical inspection required)
Installation and testing of Elevators
Installation and testing of Kitchen Equipment
House meter or Identification if Unit Number:
Other:
General Contractor Name
License #
Signature
Electrical Contractor Name
License #
Signature
Fire Authority Approval:
All required Fire Department actions and/or inspections have been satisfied and application for temporary power is
approved.
Fire District
Approval date
Printed Name
Signature