HomeMy WebLinkAboutPermit Electrical 1981-09-16CITY OF SPRINGFIELD--BUILDING DIVISION
346 MAIN sr. 726-3753 (BUSTNESS\ 726-3769 (TNSPECTTONS)
APPLICATION FOR ELECTRICAI I,ABEL(S) BY A BUTLDING OVINER
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 hjmself or a member of his jmmediate family
which is not intended for sale, Iease, or rent.
(PLEASE PRINT)
APPLICAITT' S NA.I(E leon r..//4, //ko,rEC
ADDRESS <s/l), / ? (h
PHONE
ADDRESS FOR PROPOSED WORK 1g / /il, /7(L
BUILDING OWNER (IF OTHER THAI\I APPLTCANT)
ADDRESS PHONE
f certify that al1 of the above information is true and correct, and that no portion
of any wirinq system requiring a label as applied for herein and intended to be con-
cealed by any permanent portion of the building or structure shal-I 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:
4
5
6
I
2
3
Temporary Service
Underground Service
Service
nough Electric
Cable ileat
New Circuits or
Extensions
7
I
9
Mobile Home
Connections
Signs
Swi-rmning Pools
f further certify that f will notify the Building Division when any of the above ELEC-
TILICAI INSPECTIONS are ready, that all work will be done in accordance with the Electri-
ca1 Safety Law of the State of Oregon, and that if not the building owner, I am a member
of his or her immed.iate familY.
g-i-gnature Date ?-14- f t
INSPECTION RE9UESTS SHOULD BE MADE ON THE BUILDING DTVISIONIS 24 HOUR A DAY INSPECTION
LINE. THE TNSPECTTON NUMBER r-S 726-3769. ]NSPECTION REQUESTS WHICH ARE CALLED IN BE-
FOR 7 A.M. WTLL BE MADE ON THE SAIVIE DAY.
LABEL NUMBERS LABEL TSSUANCE FEE
RECE]VED BY
FOR OFTICE USE ONLY
DATE
60
7 // - o sr