56348 -7984 FOLKESTONE
Building Permit Confirm- -5'
r Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date-------------�71.z---........---- --7 p
... 19. ermit No.--57 `3/� _-----------------'
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit to install electrical fixtures end/oriwiring as listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in anys canner so as to violal�a workmen's cor9pensafion laws of California.
OWNER VI!"1'I6 !^ P_ n°P i,
II ( LJ
ADDRESS � 1F�I Fnf �`16rC'_ lir
USE OF BUILDING Imo!jIQ -', r
FIRM SIGNED
280-201 N
70 RLL Flll ICFGTMIF Na
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service WiresI �
Recepfacles Panelboards Size Service Switch _!U "
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 Numberof Meters -
HP Phase Ampere Loads_QOQ(P—Lighfing Power
Miscellaneous
Rough Inspection gY /
Final Inspection �'—�— B _
Remarks:9s- /.3-77 �'N
280-201 N