HomeMy WebLinkAboutPermit Electrical 1981-08-28w
CIIY OF SPRINGFIELD--BUILDING DIVISTON
346 MArN ST. 726-3753 (BUSfNESS) 726-3769 (INSPECTTONS)
APPLICATION FOR ELECTRTCAL I,ABEL(S) BY A BUILDING OVINER
The Eleetrical Safety Law of the State of Oregon does not require a person to obtain
a license as an electrician and/or el-ectrical 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 sa1e, Iease, or rent.
(PLEASE PRINT)
APPLICANT,S NAI4E
ADDRESS /// /ll,/z TE R _rz 7/( - (.{4PHONE
ADDRESS FOR PROPOSED WORK /// / l4 /t 7r n
BUILDING OWNER (IF OTHER THAN APPLICANT)
ADDRBSS 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 intend.ed to be con-
cealed by any permanent portion of the buitding 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 foltowing conditions and or stages
of construction:
1. Temporary Service
2. Underground Service
3. Service
Rough Electric
Cable Heat
New Circuits or
Extensions
Mobile Home
Connections
Signs
Swi:runing Pools
4
5
6
7
I
9
I further certify that I will notify the Building Division when any of the above ELEC-
TRICAL INSPECTIOIIS -r. 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 te family.
Signature Date
INSPECTION REQUESTS SHOULD BE
LINE. THE INSPECTION NUMBBR
FOR 7 A.M. WILL BE MADE ON THE SAII(E DAY.
}4ADE ON THE BUILDING DIVISIONIS 24 HOUR A DAY INSPECTION
LS 726-3769. TNSPECTTON REQUESTS WHICH ARE CALLED rN BE-
I
LABEL NUMBERS
USE ONLY
LABEL
RECEIVED B
FOR OFFICE
DATE
ISSUANCE FEE tpC)
60
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