93281 7554 Hollanderry
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
r(�
Dafe-- -- - ---=Z-�---------------- 19�Permit No...C�3�C 6--I...............-----
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit to install cloqyyy��f'''c �fiLv r a i Vd— the revorsa side.
Exemption from req w`>< ver o ��i orr nlra ctor's License is hereby claimed
by undersigned: sr owner ❑ statement filed ❑
Undersigned af!ests that his State6'''' dornia Contractor's License ,/" LIJ
is in full force and effect and properly ly sPs this zp A /K
San Jose Cit Business License # h {/
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any mann so as toviolate the w rkme compensation laws of California.
OWNER
ADDRESS SS
USE OF ILD
FIRM SIGNED Zl
FORM 280-10 (8/08) IOM
'7gSn T-7 ,11ananrry ,J Dodd
ITEMIZE THE// FOLLOWING New Old
Outlets T Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires Y
Receptacles _/3 _Panelboards Size Service Switch
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
eters -/HP Phase Ampere Loads Lighting Power
Miscellaneous / p
Rough Inspection A B
_ Y n
Final Inspection "'�,�—�l B _ �a).,d An i
Remarks: /D ,Uf_G, o) �cvld� y
JUS
!` 23-70 '_,.rt '+�.�.it r �• � �-1,� � ��'9