17075 902 Fort Baker Dr. Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT ;0-�
1--7
—7 ` ` / 7a 7sey7
Date-.--------------------- --....2-7-.. 197- ermit No.---------
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The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit to install cl rico ,�nel/�J y%i r' }�a sled on the reverse side.
Exemption from re u' or t$fe�of/CS if ia`or Contractor's License is hereby claimed
by undersigned: as own ❑ statement filed ❑� 0)4 \3,57C—
Undersigned attests that his State aiifprnia r o y' a ? Oc J
is in full force and effect and properly �horiies i a
San Jose City Business License r�. B;f D.
�. I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as o viola the wbrk n's compenti
saon laws of California.
OWNER
ADDRESS �—
USE OF B DI G l�/ L
FIRM _P SIGNED
zee-Io
902 Fort Baker Dr. Lifetime Pools
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps - Dryers KW Size Sub Feed Wires
Ranges KW Heaterz KW Number of Circuits
Signs Transformers Motors,- � Number of Meters
HP Phase mpere Loads Lighting / ower
Miscellaneousac
SP
Rough Inspection ,( p
Final Inspection T U �2 Ug ���
Remarks: /� y ,