36072 r F.
: s47 ppe�t
Building Parmi} Confirm j0
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMMENJ
APPLICATION FOR ELECTRIC AL�ERMIT
6 ?0�
Date........ ....._S l 2 ----`---- 19..7Sermit N .... -----------------------------------
The undersigned hereb akes appl�O �
Ele5ctrical InI .to' of the City of San Jose
for a permit fo ins#all e c r' se s IgA the reverse side.
Exemption from re f ractor', License is hereby claimed
by undersigned: as ownstatement filed ❑
Undersigned aitas}s that his 54a4e a' Celiforr�a Con#rattor's License # �'3 'F CFO CS3
is in full force and effect and properly a.thorixel ifOS—e pplicat'
San Jose City Business License I-
I
yS �Rn i
I certify that in the performance of the work for which this permit is issued I shall not employ
any parson in any manner so as to violafc the workmen's compensation laws of California.
OWNER ITU/ S J�inr�er
ADDRESS lee
USE OF BUILDING /f-/ _
FIRM fon/_r SIGNED
zeo-to
G.
9
17-2
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switchesy Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch Wim/
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Si_e Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _
Signs Transformers Motors �' Number of MetersHP
_
Mi an Phase Ampere Loads�Lighting - Power
Miscellaneous �jtNin� �oo�
,Rough Inspection By
Final Inspection 9'Z- 71,�— By
Re/marks: 7_/g.n73— L��t.F�a� tY�rte^Gl... -r-�aa,+'� .�-o'a• .0--;•• o'
awSr NY�cf'rJ�,n �
,7