50275 (2) 7551 Bollinger Rd. 7~,. ., Building PeConfirmed IC
Not Requireedd
CITY OF SAN JOSE (/� '4�_-77 BUILDING DEPARTMENT
APPLICA/THI FOR EELECTRICper�PE^R�MIT
Date-----------------"� j-'1-.----------- 19. C. Permit No.--\a-.------ J-----------------
The undersigned h aby makes application to the El e frical spector of the City of Sen Jose
fore permit to install electri al fi ur n iri as li d a rerorso side.
Exemption from require n e' r r or's License is hereby claimed
by undersigned: as w er ❑ statement filed ❑ 6
� Undersigned attests that his State of California Contractor's Lie nee #
is in full force and effect and prop ui orixes this application. /
,,' San Jose City Business License #
(("d I certify that in the pe rf are f rk for w i s ri i iss d I shell not employ
f r*any person in any manner s to vi a e work �s com ns ion aws o California.
OWNER
ADDRESS o l
USE OF BU ING
FIRM SIGNED
0- Oln
1 Bollinger Rd. Hill
ITEMIZE THE FOLLOWING �3,7fo 0-l'- -Qps1 vvanr\ New Old
Outlets Panels, Cabinets Size Service Condui#
Switches _�_Switchboards Size Service Wires
Receptacles 4 Panelboards Size Service Switch _ 1�
Fixtures _4_� Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers L KW Size Sub Feed Wires /
Ran�ges�[ KW Heaters KW_ Number of Circuits
igs ns / Transformers Motors Number of Me+ers-
HP Phase Ampere Loads Lighting Power•
Miscellaneous
Rough InspectionBy
Final Inspection _ H— �{—7 `� B
Remarks: 1—\8-'1'1 S,EJ\••(V Y
q-
280-201n