94319 (2) 1284 Prdmrose Way
Building Permit Confirmed �(y
V' Not Required
CITY OF SAN JOSE BUS DING DEPARTME
AP LICATION FOR ELECTRICAL PFMM�Date-_�j/-�_ .-�!.'..�...'.-----.-�. 19--: :•Fermi# Nc --- .�- /_-)---------
The undersigned hereby makes application'to h\EI cttical Inspecf—a of the City of San Jose
for a permit to install eloe�ncel fi Jfee an on/wv,nq s lWe'd�on,f,reverse side.
Exemption from requirement for6iate'of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ? /
Undersigned at'esis that his State of CaliforiAContrac� s�Lieem; _ � 7
is in full force and effect and properly aufhoiixes rfhi application.
San Jose City Business License # �` 00—
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any mannerto violate the workmen's compensation laws of California.
so s
OWNER � 0 ,o
ADDRESS �� —/ //O/A y XAMC7-17,35'
USE --OFF BUILDING crit/ - I—~' 'A6 -�Oo
FI RtJ 09M/ oA-" A 'A '^ SIGNE Z
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1284 Primrose •(4aY'; r.." .i;�' Johnson
ITEMIZE THE FOLLOWING New ' Old
Outlets Z Panels, Cabinets Size Service Conduit I /y
Switches 3 Switchboards Size Service Wires z
Receptacles Panelboards Size Service Switch
Fixtures _� Fesfoon Lamps— Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _�z
Signs Transformers Motors -/—Number of Meters
HPA� Phase Ampere Loads A/ Lighting Power
Miscellaneous/[^ /—y �?�QoD "�/yrs
Rough Inspection G �Cj
!LQy—
Final Inspection
Remarks: 2 By
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