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0 Datemy OF Permit No.
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Fee 53 BO
<N Application is hereby made to the City of Cupertino for a permit to install electrical
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W I wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
00 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
S N City of Cupertino, and all other laws applicable thereto.
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Own/e[/' Address
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State License:
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