38390 1043 NOVEMBER DR.
I . Building Permit Confirmed
/�. Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTYT�
APPLICATION FOR ELECTRICAL PERMIT
p
Dafe --- 19\ Permif No. ✓�-Q. ..L -------------------
J
Tha undersigned hereby�rmyykas application to the Electrical,Inspec�o�of,fhe City of San Jose
for a permit to install elfctrical itfu�e2icl�o,�r/7�,'in�,nQ as�TBif1 d e i rev rse side.
Exemption from re I40
em 4 aJr�l5ta� brf�CBlifmnii:V0, Cy�cf jle�L ense is hereby claimed
by undersigned: al owner statement {filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly aufhorisAjihis a ti ati n. � /�
San Jose City Business License #
I certify fhat in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER 1S1nL,:!R \ c . e_r1c e_
ADDRESS
USE OF BUILDINGe Fc.v_
FIRM SIGNED
280-10 (9-73) . 9
103 NOyEN$ER DR. RO !
ITEMIZE THE FOLLOWING New Old
Outlets - Panels, Cabinets Size Service Conduit
Switches Switchboards I Size Service Wires _
AA
Receptacles Panelboards Size Service Switch leo
Fixtures ,3 Festoon Lamps Size Sub Feed Conduit
Mercury Lamps - Dryers KW Sire Sub Feed Wires
Ranges KW Heaters KW Number of Circuits _
Signs Transformers Motors Number of Meters
HP Phase Ampere Loads _V_�Lighfing Power
Miscellaneous
Rough Inspection2'L--77'75—" py
Final Inspection 7 -Z-�`/iF: By
y
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