45878 1135 Hollyhead Ln.
r Building Permit Confirmed
Not Required ❑
'CITY -OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date-----. /`------ ---/--, 19.,7� Perrnit Mo.----`r.SV.�.v_------------------
The undersigned heW) makes a plication to the Electrical Inspector of the City of San Jose
for a permit to instal elac c r g s on the reverse side.
Exemption from prem or a o lit or ontractor's License is hereby claimed
by undersigned: as owner ❑ statement filed i]
Undersigned a}lests that his }e of Califo is o c s =e #�—�.�� '��'��
is in full force and affect and rop �u�or' fio
San Jose City Business Licer.- �C
I certify that in the performance of the work for which s permit is issued I shall not employ
any person in any manner so as to violate the workmen' t i
s compensation laws of California.
OWNER
ADDRESS1.4
S
USE OF BUILDING_—� e
FIRMe �Y'�51GNED 2�
0-2
1139 Hollvhead Ln. A & A Elect. 9
ITEMIZE THE FOLLOWING New Old
Outlets _- ' Panels, Cabinets Size Service CoAe
Switches Switchboards Size Service Wi
Receptacles _ZZ Panelboards Size Service Swi
Fixtures Festoon Lamps Size Sub Feed Co
Mercury Lamps Dryers KW Sife Sub Feed W
Ranges KW Heater KW Li�Number of CircSigns Transformers Motors Z - Numbe o Met
HP - 7,—`v Phase Ampere Loads Lighting power
Miscellaneous ,- A
Rough Inspection ✓�/ " 7 l+ By
Final Inspection �, --� By
Remarks: �_l�j•�/l ((� o'l.e.'f�Pa�. � �„� � "1/-�
�' vara, C� W� aJu lt!rf r( p/c�dc 280-20,
03)
o(�tc _ /o L �sysrwa�/3 R- 1 7b S.E, �ly�