9695 1104 Elmsford
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMM
APPLICATION FOR ELECTRICAL PERMIT
Th�� q .
Date - ----------------- '197... Permit No._........!..6 3.. .... ......
under nad hereby'm sap i II I Inspector of the City of San Jose
fora permit to ins+ell elatfric f' r r n I }ed on the reverse side.
Exemption from requirem etc { li o is r Contractor's License is hereby claimed
by undersigned: as ner ❑ s+a}amen+ filed o1 � �w v x,10
Undersigned attests the} his State of Calif on+ractor's License
�(
is in full force and effect and properly authorize s-,
San Jose City Business License #_� ME "
I certify that in theerformance of the work for which this permit is i sued I shall not employ
any person in any mann.r so as to violafe the workmen's ompensation laws of California.
OWNER
ADDRESS ��`L
USE OF BUILDING
FIRMl�/ xG SIGNED
280-101
1104 Elmsford Sisler Electric �-
�i"Lo-�/fel �v.w eG.r/u•n 7O..rue.r.[.d C+l�v� r�w•urY.Oeee. .1�J)�drlrf.7. �3wY'
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit p
Switchest e_ Switchboards Size Service Wires C
Receptacles Panelboards Size Service Switch
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 — 1 Number of Meters
HP .c"� � Phase Ampere Loads Lighting Power
Miscellaneousr-"r
Rough Inspection By
Final Inspection 3 A-,;>L By,!'�
Remarks:t 1Y-)/ �IJ W/o�{ry„e(.unat '4A'tX'
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