Electrical
Contractor’s
Planning and Development Department
T 250.361.0343
Permits and Inspections Division
F 250.385.1128
Authorization
E einspections@victoria.ca
1 Centennial Square
Victoria, BC V8W 1P6
To the Chief Electrical Inspector:
A. Installation
Electrical Permit No.: _________________________________________________________________
Installation name: ____________________________________________________________________
Address: ______________________________________________________________________________
B. Registered Electrical Contractor
Name: ______________________________________________________________
Registration No.: ______________________________________________
Phone: ____________________________
Fax: __________________________
Email: _________________________________________________________
C. Declaration: To the City of Victoria (and supply authority if required)
Field Safety Representative (FSR) Number:
Class:
I, ___________________________________________________ , a registered FSR for the above contractor, ensure the regulated work under the
above-mentioned permit complies with the requirements of M58 Electrical Safety Regulation, M63 Safety Standards General
Regulation, BC Electrical Code and City of Victoria electrical bylaws.
YYYY
MM
DD
FSR Signature:
Date:
Work in progress
All work is complete
Occupancy
Installation is safe (6 month safety check)
YYYY
MM
DD
Date:
Rough wiring as noted below may be covered on:
Complete
Partial (specify area): ____________________________________________________________________________________________
Slab
Ufer ground
Underground
Electrical installation is ready for connection as noted below:
New Service
Temporary Construction Service
Service Repair
Service Change
From: ____________________________________
To: ______________________________________
Type of ground electrode
Rods
Ufer
Plate
Other: _____________________________________________________________________
Voltage (line to line)
AMPS
Phase
Electric Heat
Service Characteristics
V
A
Ø
kw
YYYY
MM
DD
have been corrected
Deficiencies of:
Remarks:
Installation as noted above has been accepted on the basis of the
Name (print):
Qualification of the Electrical Contractor’s Registered Representative
YYYY
MM
DD
Electrical Safety
Inspector Signature:
Date:
White – (top copy) Applicable safety authority
Green – Job site
Pink – Supply authority (when applicable)
White – Electrical Contractor
|
City of Victoria
ELECTRICAL CONTRACTOR’S AUTHORIZATION
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