12697 (2) 7556 Bollinger
Building Permit Confirmed (sy
Not Required ❑
CITY OF SAN JOSE BUIL.DING DEPARTMM=T
APPLICATION FOR ELECTRICAL PERMIT
Dale -_._........................ ...."..¢p.{/�Q� ermi No - .----
The undersigned hereyy ryek i i c Pector of the City of San Jose
for a permit to install el . ores or wiring as lisle on the reverse side.
Exemption from requirement or State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that hi ate of Calif m Co 4 w ns a%�f/'
is in full force and affect and r au4 or' s
g r
San Jose City Business Lic r y
I certify that in.}he performanceof }he work for which this pe'rnt is issued I shall not employ
any person in any mjpn5r so as fo viol fe the workmen's compensation laws of California.
OWNER
ADDRESS S3 acetic
USE OF BUILDING
FIRM SIGNED
z17+556 Bollinger\
Elec . Serv.
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit _ I
Switches I Switchboards Size Service Wires
Receptacles � Panelboards Size Service Switch -/UD
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 Number of Meters _
HP Phase Ampere Loads 7�_Lighting Power
Miscellaneous
Rough Inspection
By
Final Inspection :. 1Q-7j Bye y�
Remarks:�/•2-7/�//
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