92866 (2) 1655 Sar=Sunnyvale
Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE BUILDING DEPART S .L
APPLICATION FOR QELECTRICAL�PJERMIT
Da#e- /J-/'- --------------------------- 19 0 Permi4 No.-------[--- - ------------
Tha'undarsigned hereby applica+ion to the Electrical Inspec4 r +he City of San Jose
for a permit to install ale ical xt a as rY arse side.
Exemption from requi to o o n# License is hereby claimed
by undersigned: as ner ❑ statement filed
Undersigned attests that his State of California onfrraa f.r's License #
is in full force and effect and properly/authorizes this ¢ftcation.
San Jose City Business. License #{
I certify that in the performance of the work or which this permit is issued I shall not t employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS `SS^ / f��n -'c ,u'V't IAOCAKico-
USE OF BUILDING G C�trov U�? x
FIRM C-Cde SIGNED b
FORM 280-10 (2/6J) IOM p
1655 Sar-Sunnyvale Dias 7
ITEMIZE THE FOLLOWING New Old
Outlets /may Panels, Cabinets Size Service Conduit r
Switches Switcbboards Size Service Wires St's
Receptacles Panelboards - _Size Service Switch ¢�
Fixtures " y
�/ 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
eters _HP Phase Ampere Loads Lighting Power
Miscellaneous
Rough Inspection
qFinal Inspection By.-2�---�� By
Remarks: