22567 (2) 7689 Peach Blossom
/ Building Permit Confirm �
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
/- APPLICATION FOR ELECTRICAL PERMIT
Date........ 25..-`-------------------- 19,73 Permit Noxa 5�
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The undersigned hereby make appation�4offh9 E�ef �h�Qpector of the City of San Jose
fora permit to install elec4r of& rap,d7 rrllrW1 ys` yfedjo�fhir reverse side.
Exemption from requirement fo Sfete of California for Contracfor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his o ata of Califorani.]Contracfor;.LiEem�e e'// .Q�
is in full force and effect and properly authorixa�t i✓s app ca_iien'✓�Y v�
San Jose City Business License # `
I cerf;fy that in the performance of�t+'work for whit this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS ��� !%1
USE OF BUILDING Jz
FIRMG� ��� SIGNED
280-10
I
i
ITEMIZE THE FOLLOWING New Old
Outlets / Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles> Panelboards Size Service Switch d"O
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,;2!Z 'Lighting Power
Miscellaneous • fn
Rough Inspection By
S Final Inspection By
Remarks:4-lel-7
3
BX.l'w r
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