68695 801 Miller Ave.
\ Building Permit Confirmed
•1 .. Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
PPLI ATION FOR ELECTRI ERMIT
Date----- f- 7 ---'------- 19........ Permit No ..............C.9869-67
-...r... .-------� — ------
The undersigned hereby:makes application to the Electrical Inspector of the City of Sen Jose
for a permit,to install electrical fixtures and/or wiring as listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ z4e4emant (ilad i
'- Undersigned attests that his State of California Contractor's Licenso
is in full force and effect an properly authorize application.
an Jose City Business Li ense_�F G� 72-
I
I erti y t i o orf rman a th rk (or ich hi ermi4 s 'ss4ed I shall n employ
nyp 'so i n vi la a the orkmen s co a Safi s Nfl r
tOWNE 1
r j ADDRESS
O/
h USE OF BUILDING
C) FIRM SIGNED
280-201N
801 Moller Ave. ?._ - ' A & P I�
ITEMIZE THE) .FOLLOWING New. Old -.
Outlets / Panels, Cabinets Size Service Conduit '
Switches L' Switchboards, Size Service Wires
Receptacles __/ Panelboards - Size Service Switch -l�V
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 4�2Lighting Power
Miscellaneous p
Rough Inspection ,� By �/'
Final Inspection 3 a(n Q' 11 AnI 4AM
Remarks: By y
280-201N