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2. Small Generator Interconnection Certificate of Completion
4. Applicant
6. First Name*
7. Last Name*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Fax Number
18. Email Address*
20. Installer
21. Check if owner-installed

    1. Yes
    2. No
23. First Name*
24. Last Name*
26. Address*
28. City*
29. State*
30. Zip Code*
32. Phone Number*
33. Fax Number
35. Email Address*
37. FINAL ELECTRICAL INSPECTION AND APPLICATION SIGNATURE

    The Small Generator Facility is complete and has been approved by the Washington County electrical inspector.  A signed copy of the electric inspector's form indicating final approval is attached.  The Interconnection Customer acknowledges that the Small Generator Facility is not ready for operation until receipt of the acceptance and final approval by Forest Grove Light & Power (FGLP) as provided below.

39. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
41. Electronic Signature
42. Signed copy of electrical inspectors form *
44. Acceptance and Final Approval of Interconnection Installation (for FGLP use only)

    The interconnection installation is approved and the Small Generator Facility is approved for operation under the terms and conditions of the PUC Rule OAR 860, Division 039 and a duly signed and executed Interconnection Agreement:

46. FGLP waives Witness Test

    1. Yes
    2. No
48. If not waived, date of successful Witness Test
49. Passed
51. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
53. Electronic Signature

55. *Interconnection shall not be deemed complete and ready for operation until the Applicant has completed this form, secured the necessary attachments and signatures and submitted to Forest Grove Light & Power Department.

Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit Submit and Print

* indicates a required field