38967 (2) j19`�CRESTLINE DR. Building Permit Confirmed
I I Q Not Required ❑
CITY OF SAN JOSE � BUILDING DE �
APPLICATION FOR ELECTRICAL PERMIT
�, c�lpze
Date ............�j,-- ----- ----------------- 19-------- Permit No.---3-�n-0 -----
The undersigned her Maso.ner.,Ej
a 10 a Inspector of the City of San Jose
for a permit io install le a si on the reverse side.
Erempfion from r iremo{ Cali .rote for Contractor's License is hereby claimed
by undersigned: . statement filed '/
Undersigned at}es}s +ha! Sta} Cali{or 'a'Cont act F's icense # c�9'S�`(a`F
is in full force end affect and pr p I aulr riz ti Iic i r.
Sen Jose City Business L' se
_ I certify that in the performance ofaFework or which f0 pa it is issued I shall not employ
any person in any manner so as io violate }he workmen' com pensa+ion laws of California.
OWNER
qy
'ADDRESS
USE OF BUILDING
FIRM SIGNED JL O
280-10(9-73)
ISMI
oN, .
ITEMIZE THE FOLLOWING New Old
Outlets / Panels, Cabinets* Service Conduit
wi
5 tches Switchboards Sizeervi
S ce Wires
res
Receptacles Panelboards Size Service Switch /00
Fixtures / Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Sire Sub Feed Wires
Ranges KW Heaters KW Number of Circuits
Signs Transformers _ Motors Z Number of Meters
HP I t Phase_ Ampere Loads�f�cZ,_Lighting Power
Miscellaneous //��
2
Rough Inspection \j By
Final Inspection _S-- .
Remarks: 5� 75'- �r4"ae % t' B't'Qzt.�. �y A
.Gr qe��f'1_
a ur .'/G���J '6 Vin-eQ!` a/-X3-7T04E
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