30573 908 Rose Blossom Lane
Building Permit Confirmed ❑
7`f Not Required 4E3—
CITY OF SAN JOSE 7 BUILDING DEPARTMENT
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'''' APPLICATION FOR ELECTRICAL PERMIT
Dafe- G/------------ ------
191. Fermi+ No.---- fJJ-f-�------------------
Thed her makes pli ation to 1 Falectric I`Inspec4or o{ the City of $an Jos.
for a stall a I r in li. the revers. side.
Exemption from r r o if f ( nntractor's License is hereby claimed
by undersigned: as owner ❑ statement filed [I _C 1
Undersigned attests that his Slate of for Contra tors License #;!7—,
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is in full force and effect and properly eu o
San Jose City Business License #--
I certify that in the performance of the work for which this permit is is d I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS
USE OF BUILDING
FIRM ` ��2/�/ SIGNED
280-10
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
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 f Meters
HP Phase Ampere LoadsLighting Power
Miscellaneous
Rough Inspection B 7
Final Inspection By— L/
Remarks: