HomeMy WebLinkAboutPermit Electrical 1985-12-27
.
J
.
QJ
~~(t)
CITY OF SPRINGFIELD--BUILDING DIVISION
346 MAIN ST. 726-3753 (BUSINESS) 726-3769 (INSPECTIONS)
APPLICATION FOR ELECTRICAL LABEL(S) BY A BUILDING OWNER
Ii:,f' c;- D /3~
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 ~ /; ! Ifrrl /(- . 6/l L T/f J( 0 9
51. SPr, ",C}.(,~ /)
I
6/c;."cI€ V-
ADDRESS c:? (0 f 7, S 1'\,
PHONE
7.z~ -3A7~
ADDRESS FOR PROPOSED WORK
SI" (P):2
BUILDING OWNER (IF OTHER THAN APPLICANT)
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:
l. Temporary Service 4. Rough Electric 7. Mobile Home
2. Underground Service 5. Cable Heat Connections
3. Service 6. New Circuits or 8. Signs
Extensions 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 o~oren, and that ~if n~ building owner, I am a member
of his or her imme~iate family. / // &#'~
signatureC: ~~ j, /- ~ - Date 1;;2-,;) "7-1'6"
- --
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-
_____________________________~9~_9~~!~~_~~~_9~~_______----------------;9---------------
LABEL NUMBERS -it 09/6 B LABEL ISSUANCE FEEf - d- 0 .
RECEIVED BY ~ _ DATE Jd---;7/}-J'S-
(f