28505 r 903 Rose BZOS$OIII Dr. Building Permit Confirmed P-
Not Required ❑
CITY OF SAN JOSE BUILDING DEPART ENT
APPLICATION FOR ELECTRICAL PERMIT
D
Date .. .. ..A ............. ---.... 19- Permit No .............. - .._ .....
r
The undersigned he m kes applic }ion to } IRctric pector of the City of San Jose
for a permit to instal els r' I re wi ng the reverse side.
Exemption from ui r f ori for ntractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned of}esfs that his State of Calife Contractor's License
is in full force and effect and properly amu;lsoa �pS .' 'applic s
San Jose City Business License # /6f(�,•�
I certify that in the performance of the work for,which this permit is issued tl5hall not employ
any person in any manner so as to vio to the workmen's compensation laws of California.
' OWNER 5
ADDRESS Ste\
lic—
USE OF BUILDING
FIRM �1 � SIGNED
280-10
I
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires a-
Receptacles Panelboards Size Service Switch �d O
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 -I,— Number of Meters _
HP �((y/ Phase—Ampere Loads _ pp
8(Lighting Power
Miscellaneous Q20/
Rough Inspection By
Final Inspection By
op Remarks: (/j
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