1858 (2) NO. STREET , LOT No.
APPLI ATIO,N 21 FOR ELECTRICAL PERMIT
VIAN
9.-Il CITU-yOF,CUPERTINO
Date A 19,63 Permit No.
Fee 'S
Applicafiplj'id hfhZ 4d th� of Cupertino for a permit to install electrical
wiring anY)or 11fix'ttuures as listed-flo��n fireverse side,hereof, and agrees to install said
wiring and/or fixtures in accordance with,the prod inions of the Electrical Code of the
City of Cupertino, an Il other,law's'a�.applicalile.'thereto.
v Use of Prem r�
Owner Address o
a
ro By Address
CONTRACTOR, AGENT
/J �f �r .Approved iLt-PSL +
Phone: ll— -2 I e�C n I ELECTRICAL INSPECTOR
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I, the undersigned do hereby certify'-that I
I am the I owner and A6ccuparit ?f�h& single i
family"Idwelling at �n.��� ��ca- ;
fg; ic ' I am aking applibation to do
( ` work as a homeowner.
I also %�certi at I will not hire any
non-licensed or contractor,
but will do this work myself.
ELE R .SERVICE NOTICE OFFICE
COPY
BUI DI G INSPECTOR'S OFFICE
CI Y Oh CUPERTINO
. ..t...,....----------- --- 190..--
To
You are herebyautho t to connect thjEL CTR service forr Owner or Tenant ' .._ _.
i
I At ...........L..S2.Z.]...0.....
40�_ -- -........ ............
No. of Wires .��j.. ----_....... Size of Wires* ... Size of Switch
Motor Load Voltage .. ............................. Phase.............................
Heating Load K. W. ......----------- ---------------- Voltage
'T:igh[ ............_t'10 ...'. .•._-�Nep—Srnim'" �.�..neeonnect> y.1i,e
No. of Meters .................... ............_..Three e... ......._..._Move Service ..........
Heat ..............220
No. of Add. Meters ...__.... Power "'
--............ Three has
i QLoca i 2 �Q..
�� EL I
-- y-104 7%61;500