NO PERMIT NUMBER //033 OLAI'Vo✓ z/aa LOT NO2 /
NO. STREET
GY C =,.C.t 7 CITY OF CUPERTINO
APPLICATION FOR ELECTRICAL PERMIT
JUN `l - 191
11 Permit No.
Date 7 �� ' !i ,19_ Fee$ .{
Application is hereby made to the City of Cupertino for a permit to,install a el ctrical
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
City of Cupertino,and all other laws applicable thereto.
Use i /�L y Performed
To Be
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Promire l�4 E / Performed /�
Owner. 4;4254 444 Add... l0 IPS-4 .1?E� A6-
Phone�S�'�J Y r
9 IIcico Electrical Contractors, 'He. Address ;WO
Y Contractor,Agent
PhoneState Licenw C-10 759308 Approved
al In actorI AGREE I WILL NOT VIOLAT ANY OF THEN'
COMPENSATION LAWS OF THE STATE OF CAL OR
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