49368 (2) L. 5825 Bollinger Rd.
Building Permit Confirmed a
Not Required ❑
B9UILDING .DEPARTMENT
APICATION FOR ELECTRICAL PERMIT 6Z 70
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uG s�
Da+e-/-�` a...L - ' ' . 14.7.L-14.7.L-19. . PermitNo.- / /-- .........................
The undersigned hereby makes 'application to the Electrical Inspector of the City of San Jose
for a permit to install electrical fixtures and/or wiring as listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned:* as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # ZS(27r/
is in full force and effect and properly authorizes this application.
San Jose City Business License '$k y 7 — 0_ 0
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 L u'T-L4 F 2 A n/ Lk, LZ R G i, o f oun SAv/ a0�
ADDRESS LL i 11/
�• USE OF BUILDING F D U C14 T/ D W 1-3 V )-,Q-
' FIRM 1325 V -4 ✓Y S A-k/F- %• SIGNEDy�
'• 280-10(10-69)
5825 Bollinger Rd. Y Bevans Elect.
ITEMIZE THE FOLLOWING tz"' NuGOId
OutletsPanels, CabinetsSize Service Conduit
Switches Switchboards _Size Service Wires
Receptacles 3 Panelboards / Size Service Switch /} + IP
Fiztures�SNZ. -,11,0Flo 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 �12 moi?
a Phase 1W Ampere Loads Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection 79 B ,
Remarks: \1-B-ll, I%�� k" QS, y
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