88162 (2) 1034 Pennington
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION
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The
FORELECTRICAPERMIT
Dafe.....OT � U196pp. Permi# No..........sn-WG
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The
undersigned hereby makes applli$ation to A ElectricalInspectorof the City of San Jose
fore permit to ins#all eke �ql'�x ur ga.p-;O ^g�s�i�4ed/en�the reverse side.
Exemption from requirement f r Stale of California for Contractor's License is hereby claimed
by undersigned: las owner [Ai� statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properlyau#hori irhi40, s �plica � �
San Jose City Business License # �� J(
I certify that in the performance of the work for which this permit is issued'i shall not employ
any person in any man(nr� so�—#o violafe he workmen's compensation laws of California.
OWNER /H, 1'l�ICPY /_
ADDRESS �O 4-
USE OF BUILDING
FIRM SIGNED
FORM 280-1012/671 IOM
1034 Pennington Money
ITEMIZE THE FOLLOWING New Old
Outlets # Panels, Cabinets Size Service Conduit
Switches Switchboards Size Service Wires
Receptacles Panelboards Size Service Switch
Fixtures Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryers KW 'T"' `a Size Sub Feed Wires
Ranges KW Heaters KW Number of Circuits
Signs Transformers Motors Number of Meters _
HP Phase Ampere Loads Lighting Power
Miscellaneous
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Rough Inspection1111 / �../ py
Final Inspection .�L1' Z�(� / g
Remarks: y