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95389 7610 Hollandery .r Building Permit Confirmed Not Required ❑ CITY OF SAN JOSE —RUlL[IING DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date----------------�l-_ - ---------- 19-��..�. Permit No.J�'5 �E7. The undersigned hOreb aka a 'c io fo a lectr' Inspector of the City of San Jose for a permit to install el ct ' al I r a s c on the reverse side. Esem pfion from re o r Si o a d r onfracfor's License is hereby claimed by undersigned: as owner ❑ statement filed Undersigned attests that his Staten �ar'rnia S `c� L,jc is in full force and effect and properly s tJs�}a3""^'✓"" . San Jose City Businasi License # 1..,0/Z 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 OF- ADDRESS ADDRESS C i USE OF BUILD NG y FIRM -SIGNED ` FORM 280-10 18/681 IOM 7r10 T4^11anegary .!_ Dodd /Vf� ITEMIZE THE FOLLOWING New Old Outlets //�/ Panels, Cabinets Size Service Conduit �f Switches 10 Switchboards Size Service Wires Receptacles f� Panelboards Size Service Switch Fixtures Festoon Lamps--Size Sub Feed Conduit Mercury Lamps Dryers __I— KWht,R_' Size Sub Feed Wires Ranges KW Heaters KW Number of Circuits •� Signs Transformers Motors Number of Meters HP Phase Ampere Loads Lighting Power Miscellaneous �y� Rough Inspection 2 �` �� T py Final Inspection /L—//o'—t� By ' Remarks:-2%?7`6 f'��p,7 C[ u/�s., / / � 6 �,or c"/W ori ��c.../✓o. �ti ciS� 4rr