89464 (2) 1123 K6htiaood //
Building Permit Confirmed 2
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION
p FOR ELECTRICAL PERMIT '
Date--------------------------�. -- --1---- 19.i(4. Pernnit No.----------a.-c�-- 67....
. .....------
The undersigned hereby a es a r a on he�fFp�cfycaj/.ls�gp cfor of the City of San Jose
for a permit +o
install
ele�frrii^' F i d h¢ reverse side.
Exemption from requirem—en+ f State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filled ❑
Undersigned attests that his State of Calif rni �f�/�rn�'irac+ -Utelliy l�
is in full force and effect and properly aufhori hii,�'Ixpli V
San Jose City Business. License #U 46�
` 1.2 -/
I certify that in the performance of the work for which this permit is issued 1 shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER ���GL e t/
ADDRESS 7—
USE
USE OF BUILDING �/
FIRM 6Z, , 1�-^ '' SIGNED L
FORM 260-1012/8]1 IOM r
1123 Kentwood ��Lylev nmv 9
ITEMIZE THE FOLLOWING New Old
Outlets .j Panels, Cabinets Size Service Conduit
Switches 3 Switchboards Size Service Wires
Receptacles 4 —Panelboards - Size Service Switch < Cd
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 Lighting Power
Miscellaneous
Rough Inspection 6y {
Final Inspection � �t!A-�y�/ By
Remarks:
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