35671 (2) 7479 Bollinger Rd.
Building Permit Confirmed L7
Not Required ❑
4
CITY. OF SAN JOSE ""' BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date----------------..............Gl- ------ 19h�Permit No. ---171-----------------
The undersigned hereby makes application to th Deorica sp for of the City of San Jose
for a permit to install atectr' al vt re o r g a e reverse side.
Exemption from requir m e ai rnia for Contractor's Licensed hereby claimed
by undersigned: as wner statement filed {�/'
Undersigned attests that his State of Calif is Coniractor _license' #'
is in full force and effect and properly authopplica �/ v
San Jose Cityri s_ Business License # ti �/' `W e`
I certify that in the performance of the work for which this permit is is is�shall not employ
any person in any m er so as to viol,fe�the workman's compensation laws of California.
OWNER _�Y71�o �- Sc (`I M l !Z
ADDRESS 7q 5; O q L7
USE OF BUILDING
FIRM SIGNED
280-10 (9-73)
7479 Bollinger Rd-. H.O.
ITEMIZE THE FOLLOWING New Old
Outlets '7 Panels, Cabinets Size Service Conduit I
Switches A Switchboards Size Service Wires �Z
Receptacles Panelboards Size Service Switch
Fixtures Js T '/oh 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 Phase Ampere Loads _Lighting Power
Miscellaneous
Rough Inspection By
Final Inspection B
Remarks: 6_c�, 7�m ��l U N y