30513 1107 Hollyhead Ln. ' 1 /
Building Permit Confirmed IfJ/
Not Required ❑
CITY OF SAN JOSE BUIL ,ING DEPARTMENT
APPLICATION FOR
j> ELEC CAL, PERMIT
.,�------------- 191y- Permit No. .---...---------....
(.The under ned he 'makes ap lication to the Electri I Inspector of the City of San Jose
for a permit
to
install el /or f a 'sf d on the reverse side. y.
Exemption from r 1 r e n ontracior's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests that his State of aalifornia Contractor's License ZG
is in full force and effect and properly aujfi�a D ! �/ k-
I San Jose City Business License # ,[��/ J
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
ADDRESS
NO
/7
_ •V"v
USE OF BUILDING
FIRM
280-10 (9-73)
TiOr) FTnllvhaarl Tn_ A&A Builders
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 Heaters KW Number of Circuits
Signs Transformers Motors Numbers of�Meters
HP Phase Ampere Loads(i�Lighting Power
Miscellaneous
9 p �-7L�
Rough Inspection By—
Final
Inspection g
Remarks: y / y
-3.pyo NMS - .