22972 (2) 1575 Jamestown Dr.
Building Permit Confirmed kil"
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT _
Date-- --- . - A/� ...... _. 19.... Permit No... .��...L._�.`... .....-
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
fore permit to install ec I e n g i ed on the reverse side.
Exemption from a r Contractor's License is hereby claimed
by undersigned: as owner.❑ statement filed ❑
Undersigned attests the 5fytey of.Ca' or 'a' V t 's is s 33
is in full force end affoc# a g�(p�I au# n.
San Jose Ci}y Business teen r,
I certify that in theperformance 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
ADDRESS
USE OF BUILDING
FIRM-70
SIGNED
280-10
9
ITEMIZE THE FOLLOWING New Old
Outlets Z Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires Z..
Receptacles Panelboards Size Service Switch 127
Fixtures 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 —L
HP �� y/' //fp Phase Ampere Loads _/_,S_Light ing Power
Miscellaneous
Rough InspectionBy
Final Inspection j 0_'I,,//" 7 3 By
Remarks: 30..7,3..>°�i