36497 835 SEPTEMBER COURT Building Permit Confirmed f2�
^- - Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT,/
Date--------------'--- `� e �4% �7
------------------------- 19--7$Permit No.-----------------------------------------
The undersigned hereby make ap plica}ion +o the Electrical Inspector of the City of San Jose__
for a permit +o ins#all electric. i r s / 'ng t d reverse side.
Exemption from requiremen o +or's License is hereby claimed
by undersigned: as ner ❑ statement filed ❑
Undersigned attests that his State of California Co actor's License # � ,S
is in full force and effect and properly au#ho izes #hispL
n.
San Jose City Business License # �`�
I certify that in the performance of the work for which this permit is issue I shall not employ
III any person in any manner so as to violate the workmeds compensation laws of California
OWNER
ADDRESS
USE OF BUILDING �—
FIRM � SIGNED
280-10 (9-73)
ITEMIZE THE FOLLOWING` New Old
r
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch71y
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;f Number of Meters
HP Z Phase fp'
Loads ��
—Ampere1� —Ligh#ing Power
Miscellaneous yam' ' '� 4/I t)
I a
Rough Inspection ' By
Final Inspection B
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