15039 7811 Lilac Ct.
j Building PaConfirmed
t Not Required
CITY OF SAN JOSE 4-4-2 Z BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL// PERMIT
Date.fL>�' CL..L.L......1..Z_...... 19.72 Perrni# No..l...!�.........
The undersigned her makes applicafion to the Electrical Inspector of the City of San Jose
for a permit }o insfel e ' ur i o the reverse side.
Exemption from r o Dana r rector's Licens is hereby claimed
by undersigned: as owner ❑ statement filed � 1ag280
Undersigned attests that his State of California Contractor's License # O L7
is in full force i d effect and propei�auMtul4V!s�his�,�'
San Jose Cit Business and
Licensegrope •� !/
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any ner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS
USE OF BUILDING. L1� ^ `
FIRM r42275tR4494 L SIGNED
280-Io
ITEMIZE THE FOLLOWING New - Old
Outlets Panels, Cabinets Size Service Conduit I V4
Switches Switchboards Size Service Wires
Receptacles — Panelboards Size Service Switch IC-M _too
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 Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection l-/ — 2. By
Remarks:!/-/t,7L ��/tc, C�i R: ti^py Pc o.V�e �. ..Up fp Z,T(t AJ C