17529 1099 Milky Way
Building Permit Confirmed ❑� _.
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
l
Dafihe�../.?- -----'-------------------.... 19.J�. Pe�r��mi# No.---/7-'-"��'.�..................... ,
oder lgned a ioJryiu.�lNo Ell ceryl Inspector of the City of San Jose
for a permit to ins r yrTyrf[ sQjc+'ed on the reverse side.
E.emption from requir an+ for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his Ratof Cuff d{ jnsa Con
+raa�'e�'s7C. ify�f
is in full force anddeffect and properly authorize is epp is loo✓�s�
San Jose City Business License # g.3 d 6-5 7??
1 certify that in the
performance of the work for which this permit is issued I shall not,employ
any person in any manner so as to yiolafe the workmen's compensation laws of California.
OWNER &4 C'/ CZbl
ADDRESS
USE OF BUILDING
FIRM - SIGNE
FORM 28010 lnELb 41 I/ 99}
10P9 Milkv Wav Johnson Elec.
-- ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
"Receptacles-2— Panelboards Size Service Switch ./ao
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Sire Sub Feed Wires
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motors Number of Meters
PS
HP Phase.� 411r
Ampere Loads �' Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection By 1 .
�7
Remarks:e`—/4 - / Z _ tm U