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24617 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OFCUPERTINO N I D;NG-ELELTRI AL PERMIT NO. APPLICATION/PERMIT PING PRODR NO CMECHANICAL DENTFIC24617 4 6 1 7 BUILDING DIVISION BUILDING vROJF.(TI'IDENTIFICATION L YV� BUILDING ADDDD1R/ESS: SANITARY NO. APPLICATION SUBMITTAL DATE UNIT N LOT p CONTR C O 'S NAME: is C CONTROL IN ARCIIITECI'/ENGINEEN: LIC NO: AD ES : ^. ❑ CONT PHONE, QTY. QTY. ELECTRIC PERMIT EE BUILDING PERMIT INFO '// /�-6 f PERMIT ISSUANCE - BLDG ELECT PLUMB MECII ❑ ❑ ❑ LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL LOB DESCRIPTION pyZ IM1crcby afEnn Nmlam licensed sendsrprovisi les ,Cade 9(nnnmen<ing with /1 woo Scai.n 7000)of 'stria 3 it the Business an fessi...Castle and my,license is in PANELS yU� full force an eff'd � / FZW Liccnvc Lic.p (/fC UP TO 20o AMPS .bDam Coalman, 201-1000 AMPS —Moo S RCII11'IiCTS DECL SQ.IT.FLOOR AREA $/SQ.FT. C)zr3p 1 u rsandmyp ex,fedlbeesial spublierecmds. OVER I(Np AMPS SIGNS ELECTRICAL Y , Licensed Professional ,:,a'Q OWNER-BUILDRR DECfARATION SPECIAL CIRCUITIMISC. kOaU 1 hereby strum that 1 am exempt from the Coul.tor'm License Law for the 1+13.1- following region.(Section 703 LS,Busiress and Professions Code:Any city or county TEMP.METER OR POLE INST. F'a an;