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67571 (2) 8093 PQgsidio DT. Building Permit Confirmed©! Not Required ❑ ' CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR ELECTRICALPER/MIT Date------ ------------------ ..... 19.&- Permit No............. The undersigned hereby makes application to the Electrical Inspector of the City of San Jose for a permit to install ¢fectricd]/ Ntures end%or wwain��as listad)on the reverse side. / Iiy �.�•t I Ii!I // i Exemption from raquiremen for State of�Californiaafar�Con}ractor's License is hereby claimed by undersigned: AF as owner ❑ statement filed ❑ .j Undersigned attests that his State of California Coon}raclor's License ' �;.. is in full force and effect and properly author'," �.application. San Jose City Business License # I certify that in #he,performance of the work for which this permit is issued I shall not employ any person in any manner so�as•to.viola#o.the•workmen4•compensation•lewa•ef.Celiiornie.. Q.X'./� I` OWNER �o C'�f �t�A `� �1)� vt vt G o � � t> C', ADDRESS ��U t--� USE OF BUILDING (C t r l t7� YVL1= C `• FIRM c FI � 'aZSs"GV/�SIGNEDn a�./fin of 2a0-201N 8n9� H9 ��e� d�q D�. c' ITEMIZE THE FOLLOWING New Old Outlets Panels, Cabinets Size Service Conduit Switches Switchboards I Size Service Wires Receptacles 7 Panelboards Size Service' Switch �p Fixtures -3 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 ta—Lighting Power,,' 1 Miscellaneous p Rough Inspection o- 1 By' Final Inspection By Remarks: 4 9 Se S,Sa` 7cP I&OOV (e. 200-201 N