66543 ' 1Q85' Milky Way
W 5 f e ,s, ,d,Q De VlArg Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTM�
LL PERMIT
S
APPLICATION FOR ELECTRICRDate------.../V�✓- �3 - - - 19 0. Permi# No. ` ----- '............
The undersigned hereby makes applica}'on }o a Electrical Inspector of the City of San Jose
for a permit to insta el r' /or Aloe
n the reverse side.
Exemption from r o to Hf r is o ontractor's License is hereby claimed
by undersigned: as owner statement filed
Undersigned attests that his $fa}eof I a Con}r
is in full force and affect and properly au ihi e �6
. . San Jose City Business License #
I certify that in the performance of the work for which thisfpermi} is issued 1 shall not employ
any person in.any.man/nerAso•asatosviolafeAthe'sworkmensueompensa}ionIlaws lofn Cal ifornia+
OWNER nb gr -
ADDRESS
t
USE OF BUILDING T
FIRM f7 c�9Df1 c'P C'o SIGNED �/ n
i Cy2 0-201 N !
1Q85 'Mill[ ya� i;- Deapker y
ITEMIZE THE FOLLOWING New Old
Outlets
L Panels, Cabinets Size, Service Conduit
Switches 'Switchboards Size-Service Wires
Receptacles Aq Panelboards Size Service Switch
Fixtures In Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters &I KW2ZNumber of Circuits
Signs Transformers Motors - Number of Meters '
HP Phase Ampere LoadsAWiighting -Power
Miscellaneous
Rough Inspection py -
Final Inspection _ _ By
Remarks://-/d'-7/ S�i� / 7/-9SSL �l/ I�� 9 U✓ P./J✓/��i'
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280-201N