58871 1175 CRESTLINE DR. —/
_ Building Permit Confirmed I7
• Not Required ❑ ^
CITY OF SAN JOSE BUILDING DEPARTMENT'
APPLICATION FOR ELECTRICAL PERMIT
p7
Date.. inl�sig-riecl-
:........LL------------.. 19_ ).rPermi# No. 11.(/./�The hereb kes a p' 'o fo EI 'col ns or of the City of San Jose
for a permit to install a cfr r a no I' everse side.
Exemption from re ' emenf o fa e o aliform for on}rac}or's license is hereby claimed
by undersigned: a owner ❑ statement filed L
Undersigned atfes}s that his State of California Contractor's License #
is in full force and effect and properly aufh;rie, this application.
San Jose City BubinLic��/y,,�p,��p # CI certify }ha} in fr`Gs' ce of the work for�r r} shall not employ
any person in any maso to violate the work4e {compensa}ion aws California.
OWNER OF7 1-CA Som
ADDRESS �^ 'e
USE OF BUILDING P S P "` C
FIRM 41 e G SIGNED _
280-10
1175 CRESTLINE DR. ALD ,
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches �} Switchboards Size Service Wires -
Receptacles_d`' _Panelboards Size Service Switch t,
UO e
Fixtures / Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motors Number of Meters. _
HP Phase Ampere Loads 10 Lighting power
Miscellaneous
Rough Inspection py
Final Inspection By
marks: