70475 1101 lf6llyTTema Lane
Building Permit Confirmeds&t
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARIMfNL
APPLIC//ATIIryryON FOR ELECTRICAL PERMIT 47/R/S
Date........✓ �Sl..�-/. ------- 19........ Permit. No. ------
undersigned her aka p' ai' 1 lee,Il Inspector of the City of Sen Jose
fore permit }o install ec c } it s} d on the reverse side.
Exemption from re e r o ali ni f Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned a"ests that his State of C �Contra ors License
is in full force and effect and properly au}h0, I
} San Jose City Business License # ill.%/ /(/ �Y,
I certify that in the performance of the work for which this permit is issued I shall not employ
any person / e.
1OWNER
ADDRESS
�1 USE OF BUILDING
FIRM %� SIGNED ..�
290-201N
1101 Hollyhead bane lei=�i- �5 HO
ITEMIZE THE FOLLOWING . New Old
Outlets 9 Panels, Cabinets Size Service Conduit
Switches 3 Switchboards Size Service Wires
Receptacles —D Panelboards Size Service Switch
Fixtures _,2_�, Fesfoon 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 Phase Ampere Loads (�t�f Lighting Pov;er
Miscellaneous
Rough Inspection By
—
Final Inspection
Remarks: 7- -/ —7� ?/ ) Ib•79 uS WA•kd CL p[C
SE[u 46I
280-201 N