631 (2) i
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E'R�, S ,. LOT NO.
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pp�PLICAAy�T�o oR ELECTRICAL PERMIT
}�yp�p �Q�Q(��� OF CUPERTINO
Dat AITY l.n tUf L.t��INO 195— Permit No. /
Fee S
Application is-hereby made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said '
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the s
`. City of Cupertino, and all other laws applicable thereto. i
(\ t
Use of Premise, t
v �r
a Owner ��u ,�/P�r Address
y
ro By Address
!` ?—9 Y rS coNTRACC�oR ArJNr7 f
Approved 2J1_200Age �.
Phone:~— � ' ';s° `7 � ' P - ELECTRICAL INSP8CTD1
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ELECTRIC SERVICE TICE e0-1(' :, F
�j BUILDING INSPECTOR i FICF;
: ., c,,y
CITY OF CUPERT .",
................ ........:ra1�.1. .........................
To "
You are hereby autll ized to connect the elec service for
Owner or Tenant _\.-l.Ay....JT9TC/. .. ................. . . ... .......
// .... ...
At ... d ...... ..-_..
G// . � ..... r.. .........I........ .. .... ....
No. of Wires .....- �..�............. Size of Wires .. v.��......1... Size of Switch
. Phase.---......-
.-.._........
F'
Motor Load ............................ Voltage .........:...:a I ;:....,.....,......
. Heating Load ........................ K. W. .......................
....."....I. Voltage .-.-..........-'. `. ....,�.._ :r�:
Ili Lightk
�1 power ...... l 10.,.�l...New Service._.'........., Reconnect.................
No. of Meters....._....._....1 _ � _
/\\H ...'...•^...... ' v`_ hme Phase............... Move Service...._...::.
� ;'Three.
wile of Adci.•Meters....._2...1 ,y
T
...... .....__r ree.Wne ...__......... Ivfove Meter...........::. ?:' -e
/042/59250 ,i, .�aegt.-Ei!ECTTRICCAA II PLCi@R .s .i