2471 854 Lily Ave — /
Building Permit Confirmed'Y�
Not Required ❑
CITY OF SAN JOSE BIJILDING .DEPARjMgT
APPLICATION FOR ELECTRICAL PERMIT(
Date-. 7 ? z- ... -- 19.�.� Perrni+ No.------------- 7.--- ...................
The undersigned hereby makes application to the Electrical Inspector of the City of San Jose
for a permit to install electrical fixtures and/or wiring as listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # ,
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I certify that in theperformance of the work for which this permit is issued I shell not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER �FNMNE'S \' \1aV0!S �
ADDRESS R !;4 L) L�1 AV T \Q E
USE OF BUILDING I F ) IA-
FIRM SIGNED
280-10(10-69)
854, Lily Ave Young
r-ITEMIZE THE FOLLOWING`a�a '0 N�"w`O d `F
ufle+s Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
F11
Receptacles Panelboards Size Service Switch 00
Fixtures I Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motors _1 Number of Meters
HP 3 dd I�� 1 p�s�_Ampere Loads Lighting Power
Miscellaneous Utj f
Rough Inspection By
o Final Inspection 41-' 'L(- _)10 By
r Remarks:
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