NO PERMIT NUMBER 1215 Stafford Building Permit Confirmec!'H-- '
Not Required ❑
CITY OF SAN JOSE BU DI G DEPARTMENT
APPLICATION FOR ELECTRICAL PERRMIT,{j-4�jC)5Wv,
Date---------7.'� — -- 19..1..7.- Permit No.
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
fora perm it to install ele trlcal f' } re and/ rrwiri as listed-on the reverse side.
p 5 fA� J>^'tom
Exemption from requi�omenf� .Sfa��ef Galifornie for Confracior's License is hereby claimed
by undersigned: • s owner ❑ statement filed ❑ C7
1 Undersigned attests that his gy5� Ir'/
State of California Contractor's License # a99
`+ is in full force and effect and properly authorises this appllcafion. p
San Jose City Business License # ��
J I certify that in the performance of the work for which this permit is issued I shall not employ
I any person in any manner so s to violate the workmen's compensation laws of California.
OWNER <r o, e-
ADDRESS /91'E
USE OF BUILDING FIRM A-/3 � �" SIGNED—��r--
zao-zes rt a
1215 Stafford / — = i pig —t
ITEMIZE THE FOLLOWING New Old
Outlets /0 Panels, Cabinets Size Service Conduit
Switches /? Swifchboards*+- I Size Service Wires
Receptacles ly Panelboards Size Service Switch �C)
Fixtures _ �Z45n Festoon Lamps Size Sub Feed Conduit f
Mercury Lamps Dryers KW Sire Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _
Signs Transformers Motors _— Number of Meters
HP F/ Phase Ampere Loadsg }ing Power
Miscellaneous —j- CAj
Rough Inspection By
Final Inspection — IO " By
Remarks: 10-/k7?
280-201 N