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41472 7573 HOLLANDERRY Building Permit Confirmed Q Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR ELECTRICAL PE/R/M/IT —7 Date- - -- �z�-'-----r`=�------ 19 �Permif N..........� -/--- -------- e undersigned hereby es ap ii to EI i I/4ins pa or of the City of San Jose for n permit 10 install cla I x Y FSC%�1 Ton e r erse side. E.emption from requi emenf o State o ali or a f r o frac s License is heroby claimed by undersigned: owner ❑ ytafement filed ❑ / Undersigned attests that his Sfafo of C rnfr�_Contr nthermit'i, is in full force and offeci and properly + or; 6isaSan Jose City Business License #'I certify thatin the performance of the work for which issued I shall not employ any person in any ma er so as to violate the w //k en's compensation lbws.00ff California. OWNER ADDRESS '_`L7 Z Gfd �L / -1 " USE OF BUILDING —.v FIRIVI,�A SIGNED c. 280-10 (9-73) g 7573 HOLLANDERR`( /- b'-7C A & A 8LDR5. ITEMIZE. THE //FOLLOWING New Old Outlets ^` Panels, Cabinets Size Service Conduit Switches Switchboards Size Service Wires Receptacles '/�Panelboards Size Service Switch �Q©_ Fixtures _Festoon Lamps Size Sub Feed Conduit Mercury Lamps Dryers KW Size Sub Feed Wires Ranges KW Heaters KW Number of Circuits Signs Transformers Motors Number of Meters HP Phase Ampere Loads Lighting Power Miscellaneous aa Rough Inspection By �) . Final Inspection 2— --� By Remarks:/-7` 76� G,C�tltitc, •aArtd"_-o4,vc �