HomeMy WebLinkAboutPermit Electrical 1981-9-30
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CITY OF SPRINGFIELD--BUILDING DIVISION
346 MAIN ST. 726-3753 (BUSINESS) 726-3769 (INSPECTIONS)
APPLICATION FOR ELECTRICAL LABEL(S) BY A BUILDING OWNER
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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 :S/~/-'V6r/C.' .-?
o r/ "'- //- 7'
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ADDRESs3 Z-.3 - G
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PHONE ;7'-4- 6' - 8> --r:.s- /'
ADDRESS FOR PROPOSED WORK
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BUILDING OWNER (cF OTHER THAN APPLICANT)
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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 wi.ll 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
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Date5~? y: ~ /:70/
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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LABEL NUMBERS O,C:l f\ II 0 LABEL ISSUANCE FEE \~.~
~\~ DATE ~.?I). \~\
RECEIVED BY
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