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22277 (2) I 1191 Crestline Dr. Building Permit Confirmed Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT �— Date ...:. ................ 19r, 7 Permi# No.-------..�..Z.v.?.../---- -'--------- Thee undersigned hereb ma es app licat'on o the Elgcfric ecfor of the City of. San Jose fore permit }o install el r,~ i a wvl s o the reverse side. Ezemp}ion from rag ' a f r o actor's License is hereby claimed by undersigned: s owner statement filed ❑ Undersigned attests that his State of California Contractor's License # r is in full force and effect and pr erly aut orizes } li n San Jose City Business Licen I certify that in the perfor ca f e wo r which this pemi rt i issued I shall not employ any person In any A fo to t en=ensafion laws of California. OWNER n ADDRESS Y1 C `t ! DS P USE OF BUILDING FIRM SIGNED-VN&Lo W, - ( kvt,6 290.10 ;1191 Crestline Dr. 12-2-7S/ "HO -9 ITEMIZE THE FOLLOWING New Old Outlets ' Panels, Cabinets Size Service Conduit Switches �7 Switchboards Size Service Wires Receptacles (:i Panelboards Size, Service Switch 1 119V-� Fixtures / 1 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 72) Power Miscellaneous Rough Inspection _ 7 By Final Inspection By ,T,_ Remarks: