61926 930 Liberty ct
Y Building Permit Confirmed ❑��
�. Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
0
Date------------------------ �..JAL.... 19-7e Permit No.��? ---------------------
The undersigned here makes applica}ion to the Electrical Inspector of the City of San Jose
for a permit to install ecf'c r ri li n the reverse side.
Exemption from r r .�/ I' is r ntractor's License is hereby claimed
by undersigned: - as owner S°� statement filed ❑
Undersigned attests that his State of feja fornia Contractor's License #
is in full force and effect and properly a lko this p' at.
San Jose City Business License # �.�
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 s to "violate the worlim�e/'s compensation laws of California.
cz
OWNER
ADDRESS 3v `T `_:
USE OF BUILDING d��rc e� .� t
i;
FIRM SIGNE t
,. 2 0-201n
930 Lihex't� , i jig
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 Number of Meters
HP Phase Ampere Loads,42:2_Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection7-6• 'If By
y
280-201n