56491 1149 DERBYSHIRE
' Building Permit Confirmed
rr� Not Required ❑
N
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT ��-
KI
...... 19.;??..-
Permit No.------ ------------
undersigned 4ereby a a pl'c 'on q lac Inspec}or of the G}y of San Jose
for a permit to " �/ wir s on the ro•erse side.
• Exemption from eq a fo to ali orm f ontracfor's License is hereby,claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned affests that his State of California Contractor's License # 2311 � 'Q/
is in full force and effect add�pr_�(i6!ly authges�ili (�
San Jose City Business e e
+• I certify that in the performance of the work for which is ermlt is issued I shell not employ
any person in any manner so as'to violate the workmen's compensation laws of California.
OWNER
ADDRESS
USE OFF BUILDING
FIRM c eci / ( f'� � SIGNED � � 0-201
1149 DERBYSHIRE D' l COOK
ITEMIZE THE FOLLOWING S£wccE New Old
Outlets !o Panels, Cabinets Size Service Conduit
Switches s Switchboards Size Service Wires
Receptacles /�Panelboards Size Service Switch /z,S
4.
Fixtures �/ Festoon Lamps - Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits �L
Signs Transformers Motors Number of Meters
HP Phase Ampere Loads 403 Lighting Power,
Miscellaneous ��•,����C •`�
Rough Inspection -17 By, :
Final Inspection ".!_ /2 —78� B
Remarks: f/—A- ��1ii-J l/—e�j.7)s�
L
280-201n