58964 POOL POYAL
Building Permit Confirm,d.0�
Not Required ❑ -
CITY OF SAN JOSE BUILDING D PPAAR`TMENT
APPLICATION FOR ELECTRICAL PERMIT viD96 ReFCe-
Da+e------ - - �. _. l CA
-...-----. 19.. Permit No.------
The undersigned hereb ekes a plication to the Elnyc ric I eclor of thv City of San Jose
for a permit to install ale ri I iz r g t isf o the reverse side.
Exemption from req r a4 rn rector's License is hereby claimed
by undersigned: owner ❑ statement filed El
Undersigned attests that his State of C ifornia Contractor's License #r�3 "7 g6 SZ
is in full force and effect and properlyauf r. s apili
San Jose Cify Business License # I� �r Y
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 to violate the workmen's compensation laws of California.
OWNER L �o2O
ADDRESS
USE OF BUILDING s
FIRM �-�4O`- SIGI�E
. 280-201N
ITEMIZE THE FOLLOWING New Old
Outlets Z Panels, Cabinets / Size Service Conduit
Switches 3 Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch lc7 Q
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 Number of Meters
HP —Z��`� Phase Ampere Loads _,(L5 Lighfing Power
Miscellaneous yt,A
v
Rough Inspection ?
Final Inspection '✓ �—7 g
Remarks: y_/-78 SE/N� 4' ''7 //J aQc< 7IC
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)-13-71( � �`�`�',-12r1 CmctcPlK�Le9dI7 £.O{(��oa�-
/ 26a-2a1N