94677 (2) 1361 Sar-Sunnyvale /
Building Permit Confirmed ,lye
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
iy—
APPLICATION FOR ELECTRICAL PERMIT
Dafe----------- ------ [2--- -----2r..6----- 19.6.1.. Permit Ne.---------9-y4-2--f_................
The undersigned horeby kes application to the Electrical I specfor of A City of San Jose
for a permit to install ele ica '� iri ; s the reverse side.
Exemption from requir en at o rn a or ontractor's License is hereby claimed
by undersigned: a owner ❑ statement filed ❑
Undersigned attests that his State of Calif n ontr . C�
is in full force and effect and properly aufhory� ap i o .
San Jose City Business License # �:,-, e)7 4i
I certify that in the performance of the work for which 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 YAMAf,gM i A)1) - 2 v1
ADDRESS / -�A
USE OF BUILDING Gn 2 c(
FIRM A D /-)gd7 -TV(-- SIGNED
FORM 290-10 (5/68) IOM G
1361 Sar-Sunnyvale Ad SRT 1
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles Panel boards Size Service Switch _
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _
Signs ._ A / Transformers _ _/ Motors Number of Meters _
HP Phase Ampere Loads Lighting Power
Miscellaneous
Rough Inspection �,�n By
Final Inspection �� c—C/�(p'� By
Remarks: