36071 $91 September Ct. Building Permit Confiroa� y
Not Required C �"'❑❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date-------------------------------. ... 19-7 7Permit No.3GC7 1-. -----------------------
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit to install electrics r s t�5'reverse side.
Exemption from requireme e o iforni f ate License is hereby claimed
by undersigned: as o nor ❑ statement filed ❑
Undersigned attests that his State of Califo onfraetors L' n
is in full force and effect and properly au}hori _ applica
San Jose City Business License # L � ,
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 /UI//1"7 lJ '�12 " r"-LiPl—
ADDRESS 3 �
USE OF BUILDING
FIRM ������-0 h�rX'��SSIGNED
280-10
I
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Z Switchboards Size Service Wires
Receptacles Panelboards Size Service SwitchLUgp l
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 cQo�4I' eters
HP I�Z Phase Ampere Loads .S'i Lighting Power
Miscellaneous
Rough Inspection By _
Final Inspection ��^�g� B
Remarks: 1_11 1_11 c 1.o
6-i 7� a&
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