44666 (2) 1105 Elmsford Dr.
BuildingConfirmed ❑/
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT '
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit to install eJc�r}�e `' s / rr��/aS. i d on the reverse side.
Esempfion from rnyrehr tufo rJff� f^r6 rfY`a f'Confrac{ors License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that hiz Sfefe o alifornia�yfI or'4_JXc�en #
is in full force and affect and pr a f ori:as�{Nr�(� � 1'10
San Jose City Business License #
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.th�men's compensation laws of California.
OWNER
1 �ord�
ADDRESS M6
��� '��e
USE OF BUILDING
FIRM - Z�2 3 SIGNED \ w
2 0-201n
1105 Elmsford Dr. H.O.
ITEMIZE THE FOLLOWING _ G New old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch 00
'n Fixtures Festoon Lamps-Size Sub Feed Conduit
�( Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _
f� Signs Transformers Motors --7(—Number,of Meters _
HP _ Phase Ampere Loadsighting Power
M_scellaneoui A-C
3 Rough Inspection 7T� 6
Final Inspection V —7 y
r Remarks: /--•-I/�7CQ
ia�oati r , /�z�f p7 _� jcv 280-201n
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