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Get OR 440-0948-COM 2008-2021

Lation was completed: / / Electrical permit no.: If a temporary permit is posted at the job site, please include a copy of it with this form. EMPLOYING ELECTRICAL CONTRACTOR INFORMATION Name of electrical contractor: License no.: Business address: City: State: Phone: - - Fax: - - ZIP: State: ZIP: State: ZIP: E-mail: CUSTOMER INFORMATION Customer’s name: Customer’s address: City: Address of installation if different than customer’s address: City: INSPECTING AUTHORITY INFORMAT.

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