63469945 Rose Blossom Dr.
Building Permit Confirmed ❑
Not Required --@=,
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date...... 197g- Permit No. 6 J-..4-...
The unders' ed here makes appl'caiion to the Electrical I pector of t e City of San Jose
for a permit }o install e c r li }ha reverse side.
Exemption from re r or e o if r ontractor's License is hereby claimed
+ by undersigned: as owner statement filed ❑
Undersigned attests that his State ofo -ia Coniracto, rs License
is in full force and uaffect and properly auihoriy/q� pli
i
San Jose City Business License
1 certify that in the performance of the work for which this permit is issued I shall not employ
1 any person ia.r+sy�ssenow--sv-G—s - -
L , 1 OWNER rI �GHAE L_ MIS �tJ j
ADDRESS Ifs ROSE BLOSSOM I t/� c"AceT/NO
USE OF BUILDING YIN649 f M/Li �wELL/N
FIRM -0 ' 5270 SIGNED �y2 0-201n G
945 Rose Blossom Dr._ HO J
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 I KW
Size Sub Feed Wires
Ranges KW
Heaters KW
Number of Circuits
`
Signs Transformers Motors
Number of Meters
HP
_
Phase Ampere Loads Lighting Power >
Miscellaneous
Rough Inspection
Final Inspection
By
By G
ME
Remarks: �'�-�
/fY�2 yyLJ r /N !i �9-2g is L
CO2 iP. f G7•P d dig /CG.� pVCtl UI%�
280-201n