50275 7573 Bollinger Rd. Building Permit Confirmed
Not Required ❑
CITY OF*SAN JOSE y�a,�� BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Dafe----------------/- -/-+------.......----- 191- Permit --- -------------
The undersigne r b ekes a is tion to the ectrical Inspector of the City of San Jose
for a permit to;inst r e ��aft'Xs listed on the reverse side.
Exemption from ra n} o o if ie for Contractor's License is her y clai ed
by undersigned: as owner ❑ statement filed ❑ D
Undersigned attests that his State of California Cont actor's L'cens
is in full force and effect and properly fh this a I'c i
San Jose City Business License # /
I certify that in the performance of the work for which this ermit is issu d 1 s1fall not employ
! any person in any manner soo/A//� to violate the workma�s compensation laws of California.'
OWNER
ADDRESS
USE OF BUILDING
FIRM SIGNED
280- Oln
7 .73 Bollinger Rd, Hi.1i
ITEMIZE THE FOLLOWING 6.0 O.2, �a Q', New Old
OutletsPanels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles ��HPanelboards Size Service.Switch
Fixtures J Fesfoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers '/_ KW Size Sub Feed Wires
Ranges —/— KW Heafers KW Number of Circuits _
Signs Transformers Motors_I Number/off Meters
HP Phase Ampere Loads —,LS Lighting Power
Miscellaneous
Rough Inspection I —20=17 By
Final Inspection B
Remarks: V— 1-0��1�1. � u
-� ���d- • ..h.--�,. ZIP ` 1 �e..o � -.,.,�:
280-201n