23621 1661 Galway
La BuildingConiirmad ❑
Not Required
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/ CITY OF SAN JOSE r`� )-3 BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
- / .----------- 197. Permit No...----------...--------------'--'--....-
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1 Thi�.r�igh,reby ma s applice ion o f e Electrical Insp to of the City of San Jose
C", fpI•re perm itf }o install electri f' e n ng s s e reverse side.
p ^^^11 Exempi;on�fiom r6ggGe a o al a n or
License is,hereby claimed
s.. V yundersigned I �L LJ.' as ner ❑ statement filed ❑
,yam O O t�,,� Undersigned a+tests that his Ste a California Contractor's License
O� N islln full force and effect and proper -es hi n
(•� (�San Jose City Business License �
10Q 1 certify that in the performance of the work for which this permit is issued I shall not employ
Go 0 5 py,person in any manner so as to violate the workmen's compensation laws of California.
r. o �] OWNER .4
u °' ADDRESS n
W .) USE OF BUILDING
7 FIRM SIGNED
zLQ§to D
16 1 Galway Dr. 12 e
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch _/e2s_
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Sire Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _
Signs Transformers Motors _Number of
Meters
HP
11�,- f'4 -- Phase Ampere Loads L/7 Lighting Power
Miscellaneous
Rough Inspection !JBy—
Final Inspection —/7—7 33 By (A J R
Remarks: