54139 (2) 8159 IZ,PnESI DO`,DR.
A 6 Building Permit Confirmed (�
—z1-2,0,4e( W 1I q J.4 Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT_
APPLICATION FOR ELECTRICAL PERMITf5S7/5 5
Date G I ------------------------
L 2 � /3
The undersigned her!,�Pyx makes application to the Electrical Inspector of the City of San Jose
for a permit to,insfall ac c f u esW'pd r,wiri gr lis+f�on the reverse side.
Exemption from re rt sin f�Sf"ef �},rAf�or;fo.eon{rac{or's License is hereby claimed
by undersigned: as owner •LJ statement filed ❑
Undersigned attests that his State of Cralifornia Confrecfor's License #
is in full force and effect and properly au{harix�69;s
• S San Jose City Business License # r/
I certify that in the performance of A; work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation I of California.
OWNER1 fYl
ADDRESS t ,J
-!t
a2
USE OF BUILDING LL\+ 6f �� l,i��
FIRM G° Z5-7 — C--9-', n SIGNED Ma,,s ^v -�
zeo-zotr+
8159_ PRE$IDIQ DR. //',-;h"+�'�'"�) N.O.
ITEMIZE THE FOLLOWING New Old
Outlets _f &15 Panels, Cabinets Size Service Conduit
•Switches6��/o
pp!! Switchboards Size Service Wires
Receptacles _p___17±(° Panelboards Size Service Switch -6W /00
Fixtures —�2r__6_tc Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW� Size Sub Feed Wires
Ranges KW Heaferst KW JAL–Number of Circuits _
Signs _ Transformers Motors f2 Number of Meters _ -
HP Phase Ampere Loads
Miscellaneous ,/ Lighting Power -
Rough Inspection _Z�2 By
Final Inspection _ `7 r 10
B
Rem s:� 6'— � � /D—
77- oK(� - ,mss',,
280-201N