93967 7537 Dumas
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTtg I
APPLICATION FOR ELECTRICAL PERMIT
6Sf X5 .7
Date .........J.�... _`-Z— 19 Permit No. -- - � ........ ------------
The
- -
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit 4o inst lectrical fixtures and/or wwirfg as Ilsted on the reverse side.
Exemption fr r u' oyi.ysf r oniracior's License is hereby claimed
by undersigned: w .116`II^ siaiemeni filed ❑
Undersigned attests at his State of California Contractor's License
is in full force and of
and properly authorizes this application.
,. San Jose I y Businesy ce
I certify iha} in 4heC ma ce of the o or is is issued I shall not employ
any person in any/m351 ' s.Oiat a workme compensation laws of California.
OWNER
ADDRESS "
USE OF BUILDING
FIRM V -^^� SIGNED
FORM 280-10 18/981 IOM
, 7537 dumas JACko3n
ITEMIZE THE FOLLOWING New Old
Outlets b Panels, Cabinets __Size Service Conduit �g
SwitchesSwitchboards Size'Service Wires Z
_
Receptacles —I ' Panelboards Size Service Switch
Fixtures _1u Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Sub Feed Wires
Ranges KW Heaters-- KW Z,S Number of Circuits _
Signs - -Transformers Motors Number of Meters
HP Phase Ampere Loads Lighting Power
Miscellaneous
Rough Inspection /a—��p� B
y
Final Inspection �`-' Ile_/J�' 6
Remarks: _ ( / pB
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