23868 7862 Robindell Way
Building Permit Confirmed
Not Required ❑
` CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRI'M PERMIT
Date---A s----..i C........................... 19. 3 Permit No. - --------------
The undersigned herab ke pl' }' } bl fr1 spector of the City of San Jose
for a permit to install e t o iri �n the r¢varse side.
Exemption from req ' r a e o all r 1a or onirac}or's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of Californi Con# ac#ors cense #
is in full force and effect and properly authorize ' �ica//�
San Jose City Business License # `"I N' �i•G el
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 INN, d L'`o,hn
ADDRESS
USE OF BUILDING nSIINSIE [Ain,14 pecl jen ,o
FIRM f)IiS)�n.I Pfr1'ft SIGNED
FORM 20010 (REV. 3/Gr) IOM
7862 Robindell Way Ausland El.
ITEMIZE THE FOLLOWING New Old
Outlets —Panels, Cabinets Size Service Conduit A
Switches 3 Switchboards Size Service Wires
Receptacles ! Panelboards Size Service Switch /udfq
Fixtures 9 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 9Y Lighting Power
Miscellaneous
Rough Inspection By UJ
Final Inspection
9- d'm3kP��� �3-�3co
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