39935 (2) 1143 STAFFORD DR. '
- � Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE Z-Z--7(,, BUILDING DEPARNT
APPLICATION FOR ELECTRICAL PERMIT 41741 ' "¢
Date 42 _ /z,- - 19..... Permit No.------ .............
The undersigned herebyemakes application to the Electrical Inspector of the City of San Jose
for a permit to install electrical fixtures and¢or wiring]ds�listed�en the reverse side.
Exemption from requiiem ofvfor'State�f:CSl.foriie"for/Con4ractor's License is hereby claimed
by undersigned: as owner ❑ statement filed
E �' 3-.2 99s
Undersigned attests that his State of California Contractor's Licenas'e #�
is in full force and effect and properly autis,enppl' ems}/' nAi,7Z sv
San Jose City Business License # 44M'..`"�-/ `'`
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 a workmen's comps tion laws of Cali ornia.
OWNERS Ri�✓GC�
ADDRESS O�
USE OFF BUILDING '
FIRM ye U
VAY a
ITEMIZE THE FOLLOWING New Old
Outlets Panels, Cabinets Size Service Conduit
Switches 3 Switchboards Size Service Wires qq�+
Receptacles Panelboards Size Service Switch
Fixtures /C Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motor's Number of Meters /
HP ��- 7�• �¢ Phase _ _Ampere ds Gg Lighting Power
Miscellaneous • t//�/��
Rough Inspection By
Final Inspection Tg, By
Remarks:,)/ 5,7 -V o.Ne u^C f-Y /v or+-
W�0i ,Zy ,E�eJ> ✓� �o r l'^6 v _a� 0 Bart/
V .�w s'z�¢-� yLd.+ -'b.� %� �...rr -' y�yt /1c 80-20
o!a-✓"�--�^-P-v �1-16
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