51189 (12) e13,11 I � y P 0 o"
NO. STREET LOT NO.
f 0 ® TI FOR ELECTRICAL PERMIT
O a SEP 23 1969 ITY OF CUPERTINO
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O r �aTeY , 195 Permit No.
< Fee S 20
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a m Application is hereby made t the City of Cupertino for a permit t 'nstall electrical
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I wiring and/or fixtures as lisAnhepreverse side hereof agrees install said
0 o wiring and/or fixtures in a 01
provision o e ectrical ode of the
> m City of Cupertino, and all d ALMSLOAz� Use of Premiser�_.. _ /cg L
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3 a Ownerr' UPS '>Address
w w By �i�l ���a _ AddressS�!
QO ^^J� CON"ACCTT/OjR, AGENT A [OVe
—V Phone: �J�—��T`� pp Mlr�L
State Licenses�4c
-NEW-- RPL FEES
Size Service Conduit Number of Outlets
Size Service Wires Number of Switches
Size Service Switch Number of Receptacles
Size Sub Feed Conduit Number of Fixtures
Size Sub Feed Wires Ranges KW
Number of Circuits Oven KW
Number of Meters Panels Transformers
Signs
Misc. Dryers
Motors IIP Phase
Motors IIP Phase
Motors IIP Phase
Permit Fee 2.00
C J HP Charge
Total Fees 24