68954 1113 Stafford Dr. Building Permit Confirmed 1
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION WOR 7jE5 LEC AL PERMIT `
Date--------------?----/y---------------------- 19.7{-- Permit No...6.5.7-5---�I��/------............:
The undersigned hereby makcs,application to the Electrical Inspector of the City of San Jose
fora permit to install elec}ric�t�fiz}urys ar(d o i Inng as isie�on fJl�r�evarse side.
Exemption from requiremen oforaSte �df CeliformeraConirad4ors'License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned a0ests that his State of California Contractor's License # A(4739 ?
is in full force and effect and properly auth��ci�/il�efthis apppliiccatitiioon�.pJ/ �j
San Jose City Business License # r'�--7 �r 'V 1e� ^'
' I certify that in tha 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 VA,-L MA . T
ADDRESS 1/,/ •3 STaf�r°hel �r
USE OF BUILDING �rn
- FIRM 0(2CIo �pcTh/c SIGNED o ��
sea-so1N
1113 �t;Pgfoxd Dr, .1 � �
Buck 9_
ITEMIZE THE FOLLOWING NewOld
Outlets f Panels, Cabinets Size Service Conduit,_4y,
Switches 7— Switchboards Size Service Wires
Receptacles —__jb Panelboards Size Service Switch J C B
Fixtures - �_Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _.1'fr _
Signs Transformers Motors Number of Meters
HP Phase Ampere Loads g Lig hfing Power
Miscellaneous '
Rough Inspection
Y
Final Inspection 0 ` n - �9 By i
Remarks: C F� ap r tcU s oT L tn.. f Q r} �t u G,r�c �,wr•
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