12795 8086 Park Villa Circle
} BuildingConfirmed
Not Required
CITY OF SAN JOSE -7/1'/72.. �LLDING DEPARTMENT
APPLICATION FORELECTRICALPERMIT L
Dafe.... 19..6..` Permit No...............�2..7...�? ..----.-. .
- - - �/�,
The undersigned hpr ber4k;s pll�cvet n�-fhp�Ef ftr e�nspecfor of the City of San Jose
for a permit to installLaIectrica�fi.fur.s endr wiring as h4f6fd on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner. ❑ ^ $fffatemenI filed
Undersigned attests that his State of Califorme eConira6l��fe n ^ (O
is in full force and effect and properly aufhorizgs"fhis,epplie ti n.yyy,
San Jose City Business License #
1 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 viol fe the workmen' c mpensalion laws of California.
OWNER
ADDRESS I�LLL2(�
USE OF ILDING 1, �i �
FIR j/ SIGNED2—eo_ CGI
288086 Park Villa Circle Hill
ITEMIZE THE FOLLOWING New Old
Outlets ! / Panels, Cabinets _ I Size Service Conduit /Z_
Switches ll) Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch �(-
Fixtures / Festoon Lamps—Size Sub Feed Conduit
Mercury Lamps Dryers l KW Size Sub Feed Wires 32to2�
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motors 'Number of Meters
HP Phase Ampere Loads Lighting / power
Miscellaneous /U OD
Rough Inspection — 1'/' ;)L By
Final Inspection •/S•9 Z B,_
Remarks://-/x-�i-riYcv.c�c