31146 (2) 16 Donegal 75 l Dr.
g 7,b Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT3j�
Date------'!, /,5-�............ 19.. ... Permit No-------------!��------------..
The undersigned hereby makes applic fiw to the Elecf�cal Inspector of the City of San Jose
fore permit to install el r I i s i �tf ,r�/ e reverse side.
Exemption from r ui a ni r o or s License is hereby claimed
by undersigned: s owner statement filed %�
rp Undersigned attests that his S fe of California Contractor's License # o'b/
.J is in full force and affect and pro n s��liff _Ap�//
San Jose City Business Licens i�J�'�Cz JV�5 S
1'certify that in the performance of the work for which thishis—Tmit is issued I shall not employ
any person in any ma ''er so as to viola
OWNER �-� te the workmen's compensation law f California.. .p
l�Y
ADDRESS
USE OF BUILDINGcq
FIRM SIGNED
280-10
ITEMIZE THE FOLLOWING �oati�'3 - New Old
Outlets Panels, Cabinets Size Service Conduit
aSwitches Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch /10 U I
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub•Feed Wires '
Ranges KW Heaters KW Number of Circuits
,Signs Transform s Motors Number of Meters
H / 3
Phase Ampere Loads ! ' Lighting Power
Miscellaneous ��c// %JDU 1.Ae /J
Rough Inspection By rt
n _
Final Inspection
t� Remarks:lcl/-7'/Q �%/. _ .gy i
o( �(L1 ,�o¢ �� azrulr�tiD%der,/
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