40796 7895 BELKNAP DR.
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Da+e--------------- _ 4
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The undarsi e m s c n ' E C.
c}or of the City of San Jose
'for a permit } ins ctr' fi or in a the reverse tido.
Ezemptio om req re a for to o o forma for Contractor's License is hereby claimed
by undersigned: as owner❑ statement filed ❑
Undersigned aftests that his State of California Contractor's License #
is in'full force an effect and properly u}hori:es f i appli e '
San Jose Cw.o
�canse /
I certify irmanc of I r ich ' py i 's issued I shall not employ
any person in ,a{�}o I le the workmen's compefisa}ion laws of California.
OWNERPZ T D TVA)
ADDRESS-� �� �` �n�g cD jl-/
USE OF BUILDING S 2 DcueJh • (—
.FIRM Se�F SIGNED
280-10 (9-73) Q
7895 BELKNAP DR. H.O. I
/
ITEMIZE THE FOLLOWING j o New Old
L Outlets 3 Panels, Cabinets Size Service Conduit
Switches- Switchboards o Size:Service Wires
Receptacles / Panelboards Size Service Switch ��+D
L Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury.Lamps Dryers KW Size Sub Feed Wires
Ranges ,•q!"KW— Heaters KW •� Number of Circuits _
Signs Transformers Motors 'Nur�ber_of—Meters -
HP Phase Ampere LoadsV jt7Lighting Power
Miscellaneous
Rough Inspection
I �` se j'-'e77y
Final Inspection
Remarks:/2— ti-76-0 7S &7wytn
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