12795 (2) 8084 Park Villa Circle
Building Permit Confirmed ®!
Not Required ❑
CITY OF SAN JOSE 7//37 2 BUDDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date........... t?,S.------------- 19..// Permit No.-------------1.z--N---- ------------
The undersigned here�ymakes application fo +he �Frlectrif�Inspector of the City of San Jose
fora
permit to install elect 5I0q1filW r'ei"and or Kiri a� luted n the reverse side.
Exemption from regwromen4 for $tate of%Cehfornia for Gonfracior's License is herehy claimed
by undersigned: bas owner ❑ is statement filed L� .
Undersigned attests that his State of California Conirac+gr's License '—ry/`�/
is in full force and effect and properly au+fh'jo�rizzees•ihis�[sficJRwf
San Jose City Business License # P✓ Fdic
I certify that in the performance of the work for whic this permit is issued I shall not employ
any person in any man sorrern as +o Violat +hc workmen's m nsa+ion lawsalifornia.
OWNER /( p,
ADDRESS �a
USE OF BUILDING
FIRGNED y°
288084 Park Villa Circle Hill
43
ITEMIZE THE FOLLOWING New Old
Outlets / Panels, Cabinets Size Service Conduit L
Switches �" Switchboards Size Service Wires S
Recepfacles Ziz� Panelboards Size Service Switch
Fixtures d Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires-3 #Z
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motors _V___Number of
Meters
HP Phase Ampere Loads Lighfing - Power
Miscellaneous
Rough Inspection _ /—G-22_ By
Final Inspection / /S�Z. By
Remarks: