1201 1699 Sar-Siunnyvale Rd
Building Perm!+ Confirmed ❑
/_ Required
CITY OF SAN JOSE (D-IO-IO BUILDING DEPARTMENT
�j APPLICATION. FOR ELECTRICAL PERMIT
Date.....L.... �...'.5............. ...... 14�'..JcPermit No. /)--0/------------------------------- -
The undersigned hereby makes plication to the Electrical Inspector of the City of San Jose
{ora permi} fo install electrieel ix4 g�jjh r r' s ' �d�pn�l License
side.
Exemption from raquiramen o o r or or on a s Licanso is hereby claimed
by undersigned: as o ner ❑ statement (fled ❑
Undersigned attests that his State of California Contractor's License #.'g:?/'=l' T=2�' C/C
is in full force and effect and properly authorizes this
San Jose City Business License #
I certify that in the performance of the work for which this permi} is issued I shell not employ
any person in any manner so to vio to the w rkmen's compensation laws of California.
OWNER /
ADDRESS
USE OF BUILDING
`FIRM v ' SIGNED_ z�
POeM9280-,IOi Itl/eel IOM- /x
. / 7-i697 - San lose I
1.699 Sar-Sunnvvale Rd Mid .state
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit _
Switches t>2, 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 of Meters _
HP Phase Ampere Loads Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection --2—Z(2 By
Remarks: