93493 ' � • �
�� 873 Lily
�� , � '�(p�' Building Permii Confirmad ��/
o�v1% Not Req�ired�, � ❑
CITY OF SAN JOSE � BUILD G DEPARTME��,
APPLICATION FOR ELECTRICAL PERMIT�3��� I ,_�,
� Dafe-------�L�._----''S✓-------.... 19GJ.�Permit No.---`1..�_:Y._Y.J.-----------�f�.
� Tha undersigned hareby makes applica+ion +0 4he Elecirical Inspecfor of fhe City of San Jose
for a perm'rf to insiali elec+rical fix4ures and/or wiring as lis�ed on fhe revarso side.
EaempSion from roquiroment for 5}afe of California for Coniracfor's License iz heraby claimed
by undersigned: as owner ❑ sie#emon4 filad ❑
Undervgned aYtas}s thaf his $iafe of Cali(ornia Conlracfor's License # —•�'��yO�
is in full force and effec} and properly auf o zes ihis applica}�on.
San Jose Cify Business License $.,''� ' ���—na�O�P
I <ertify fhal in +he performance of ihe work for which }his permi} is issued I shall no4�employ
I any person in any manner so as to ��olahe ihe workmen's compensation laws of Califomia.
OWNER J F T.S�O/1'I/��'n�J
ADDRESS ���� ��'L y R yC
USE OF BUILDING �v - G'h ' �
FIRM�T/7NA/SO/U F.� �r� SIGNE/ ��r/
FORM 200-10 110/6�I tOM � S���I�� C/
873 LIly Johnson
ITEMIZE THE FOLLOWING New Old
Ouilets � Panels, Cabinets Size Service Conduit y
Switches �Switchboards $ize $ervice W+ires ��� � �,/
Receptacles Panelboards Size Service $�tch �� �d("/I"
Fixtures � Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW $i:e $ub Feed Wires / /
Ranges KW Heafers � KW Number of Circuits 6/!
$igns Transformers Motorz / Number of Me4ers /
HP �� 1 , Phase ��+Amp o ds Lighting Power
Miscellaneous p,{;� . �.4 � � —'�"�"�� �+..
Rough Inspec}ion �%'��—'/�Or� � pY
Final Inspection _� �n �7'��,➢ _
B ¢'o '.
Remarks: (0-�1-6�1 �.c-�CA„-.�..w�Co,�. /�i�e+.��..'.��-. •.,.�....�,,�
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