HomeMy WebLinkAboutPermit Electrical 1982-03-22CTTY OF SPRTNGFIELD--BUTLDING DIVTSION
346 MArN ST. 726-3753 (BUsrNEss) 726_3769 (rNSpECTroNs)
APPLICATION FOR ELECTRTCAL I,ABEL(S) BY A BUTLDING OWNER
The Erectrical safety Law of the State of oregon does not reguire a person to obtaina license as an electrician and,/or electricaf ""orrtr."a.r-a.-^i";;
"r, el-ectrician in_stallation on property which is owned by hi-mseIf or a member of his immediate farailywhich is not intendeci for sale, Iease. or rent.
(PLEASE PRINT)
APPLICANTI S NAI4E
ADDRESS Sa. Ac-:f( gt.
ADDRESS FOR PROPOSED WORK 4c*'*--*
PHONE a(- -
BUILDING OWNER (TF OTHER THAN APPLTCANT)
ADDRESS P}IONE
r certify that aI1 of the above information is true and correct, and that no portionof any wiring system requirinq a labe1 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 ad.ditional
and final inspection shall be nrade.
Inspections are generally reguired for at least the following conditions and or stages
of construction:
I
z
?
Temporary Service
Underground Service
Service
Rough Electric
Cable Heat
New Circuits or
Extensions
7
I
9
4
5
6
Mobile Home
Connections
Signs
Swirmning Pools
r further certify that I wiII notify the Building Division when any of the above ELEC-
TRICAI INSPECTIOIIS .=" 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 o\^,rler, I am a member
of his or her immediate familY.
e.)Signature Date -Ja-&s
INSPECTION RBQUESTS SHOULD BE MADE ON THE BUILDING DIVISION,S 24 HOUR A DAY INSPECTION
LrNE. fIiE rNSpECI'roN NUMBER IS 726-3769. rNspE'c'sao\I RE()'uEsTs WI{ICH ARE CALLED IN BE-
rloR 7 A.M. WILL BE IIIADE ON fHE Szu4E DAy.
I,ABEL NUMBERS LABEL ISSUANCE FEE
RECEIVED BY
FOR OFFTCE USE ONLY
DATE
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