47713 (2) 1136 Rollingdell ct
--- . Building Permit Confirmed -
•� Not Required ❑
CITY OF SAN JOSE '77 BUILDING DEPARTMENT
APPLICATION FOR ELECTRIC?C RMIT
Date--"01a I----�`'---------------- 19.Z�. Permi# No.---- .Z.Z� ---------------------
The undersi a er cafio to Electrical/Inspector of the City of San Jose
for a permit t i s a r g as listed on the reverse side.
Exemption rem r 1 ' ornia for'Contrac{or's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned a{tests that his State Car ornia C��ftf� c} ,r Lie
is in full force and effect and pro pert a i th" O
San Jose City Business License # �/
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 /�QCL2l��a 1J UCIA f
ADDRESS
USE OFBUILDING sSIA)6
�% DI
FIRM ������ SIGNED2_201n
1136 Rollingdell ct P&"R %r
ITEMIZE .THE FOLLOWING New` Old '
Outlets 1A Panels, Cabinets _Size Service Conduit
Switches _3J 9 Switchboards Size Service Wires
Receptacles �Panelboards Size Service Switch L[L� _
Fixtures 16 Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers _� KW c3 Size Sub Feed Wires ltL
Ranges o2 KW Heaters KWNumber of Circuits
Signs Transformers Motors Numberr�j of Meters
HP FM g L Phase Ampere Loads �(2_Lighting Power
Miscellaneous 5�� /Cn — � /r.,_
Rough Inspection By
Final Inspection BY
Remarks: (0-7 Q— . -9 Y.�