NO PERMIT NUMBER �.,Ly Marx
v Stelling
(] Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Dafe-'SE.PT-----/--p--------.----- 19�. Permit No....fi'�y-- iCce. ----------
The under,' ned hereb eke 1' a+' fo +he�Elect Inspector of fhe Cif of San Jose
for a permit to9insta11 q1 fri al r 0 1 en pthe reverse side.
y
Exemption from re n e of a ifornia fo Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed
UndersignedUndersigned attests that his State of Californigg o tractor's icense #
is in full force and effect and properly authorizes Al licati
.' —
San Jose City Business. License
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 . InLLYM,A N EARK) C , Tyn� SAn/✓03F
ADDRESS
USE OF BUILDING
FIRM Lewis Electric Co . SIGNED
FORM 200-10 (10/6]) 10M C'
Stelling / Carrie Circle, City Park Lewis 1
ITEMIZE THE FOLLOWING New Old `
Outlets Panels. Cabinets Size Service Conduit
Switches Switchboards Size Service Wires3
Receptacles Panelboards Size Service Switch —30A.
Fixtures Fesfoon 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 7 k
JEQ C:QA '
Rough Inspection By
Final Inspection —ot G -G By
Remarks:
mo rF F