46678 1140 Elmsford .�/
., Building Permit Confirmed'[
r Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
.
APPLICATION FOR ELECTRICAL PERMIT
"O
Dafe----- -/ - '
19-15- Permit No------"b-_.
The undersigned hereby rgp�s application c ,th ' '}rical Inspector of the City of San Jose
fore permit to install olacf c ({ffz1 Fg� /o fIr/f s listed on the reverse side.
Ezemp}ion from requir �(a if r a or Contractor's flied E is hereby claimed
a owner ❑ statement filed;
by undersigned: Z
Undersigned attests that his tateof Cali{ornia/Ce racior' ce+R,q/
is in full force and effect and properly au
rt/ho'rizes t s pPlic t, n C V
San Jose City Business License dP
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any magnet so as to vi a e the workmen's compensation laws of California.
(� OWNER
ADDRESS
J `-G4vJ
USE O/F�BUILDING
FIRM 10�* SIGN 2 0-201n
1140 Elmsford Pacific Elect.
ITEMIZE THE FOLLOWING New Old
Outlets �-7 Panels, Cabinets Size Service Conduit
Switches / Switchboards Size Service Wires ��'
Receptacles�Panelboards Size Service Switch lobed
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circui+s 2 _
Signs Transformers Motors Number of Meters
HP Phase ' Am ere Loads -�r�
Miscellaneous P /—Lighting Power
Rough Inspection
Final Inspection —"}_C(_'\(� By
Remarks: $-\3-1(
R-' 2-1 G S.C.1.OJ. �
28.0-201n