HomeMy WebLinkAboutPermit Electrical 1983-4-25
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346 MAIN
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CITY OF SPRINGFIELD--BUILDING DIVISION "\ f' 1>-?'
ST. 726-3753 (BUSINESS) 726-3769 (INSPECTIONS) ~
APPLICATION FOR ELECTRICAL LABEL(S) BY A BUILDING OWNER
The Electrical Safety Law of the State of Oregon does not require a person to obtain
a license as an electrician and/or electrical contractor to make an electrician in-
stallation on property which is owned by himself or a member of his immediate family
which is not intended for sale, lease, or rent.
(PLEASE PRINT)
APPLICANT'S NAME ctJ~ (11H1S?t:..
ADDRESS 295 ~ku tJI./Lb Rd A-2{;(JPHONE
. )
ADDRESS FOR PROPOSED WORK f ~ r\)C:::; ~ f\ (}4 ~
BUIL'JING OWNER (IF OTHER THAN APPLICANT) ...$r.J...r}t.L..-
ADDRESS
PHONE
I certify that all of the above information is true and correct, and that no portion
of any wiring system requiring a label as applied for herein and intended to be con-
cealed by any permanent portion of the building or structure shall be concealed until
inspected and approved. When the installation of the system is complete, an additional
and final inspection shall be made.
Inspections are generally required for at least the following conditions and or stages
of construction:
1. Temporary Service
2. Underground Service
3. Service
4. Rough Electric
5. Cable Heat
6_ New Circuits or
Extensions
7. Mobile Home
Connections
8. Signs
9. Swimming Pools
I further certify that I will notify the Building Division when any of the above ELEC-
TRICAL INSPECTIONS are ready, that all work will be done in accordance with the Electri-
cal Safety Law of the State of Oregon, and that if not the building owner, I am a member
of his or her immediate family.
Signature y tti~A~' 11' ~ _Date.( 4.)..J-: 8s
1\ - (/
INSPECTION REQUESTS SHOULD BE MADE ON THE
LINE. THE INSPECTION NUMBER IS 726-3769.
FOR 7 A.M. WILL BE MADE ON THE SAME DAY.
BUILDING DIVISION'S 24 HOUR A DAY INSPECTION
INSPECTION REQUESTS WHICH ARE CALLED IN BE-
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FOR OFFICE USE ONLY
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RECEIVED BY
52. I - ~
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LABEL ISSUANCE FEE
,00
4-22-R3
LABEL NUMBERS
DATE
60