90967 8187 PrAsid.io
6,J 7 Building Permit Confirmed
�
/ J Not Required ❑
CITY ,OF SAN JOSE BUILDING DEPARTME T
APPLICATION FOR.ELECTRICAL PERMIT Gf;/0
Da#e... -- ---- ------------. 1%'- Permi+ No........................ /. (0 ........
The undersign herby makes application to the Electrical Inspector of the City of San Jose
for a permit to install el$�['sc leffr d?, a l/��-101. as�IJstedPon the reverse side.
Exemption from�agl7iroArrnf'f0 ate�6f�Cahf3i�HofiContractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests Thai his State of (.Vifornia Contractors License #' ,/��S'J CI-1-3
is in full force and affect and properly:aut ai as.lbis ap t'Z
7r San Jose City Business. License #' I x
J� I 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 violate the
workmen's compensation laws of California.
~ OWNER _X�/eJ 5
ADDRESS XM7 P �/ 121 Cl
USE OF BUILDING ✓'� �G
FIRM �� SIGNED_
FORM 260-10 (10/9)1 IOM /)
8187 Presidio T&F& 7
ITEMIZE THE FOLLOWING 17,00 New Old
Outlets Panels, Cabinets Size Service Conduit vPP
Switches Switchboards, Size Service Wires
Receptacles Panelboards- Size Service Switch
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 —l- //`211f Phase Ampere Loads Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection By _
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LO -Nca-+r� �b�S-7
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