NO PERMIT NUMBERC'uk dJ �srA DQ LOT NO, O
NO. STREET
CITY CITY OFCUPERTINO
JEAN n _ 11APPLICATION FOR ELECTRICAL PERMIT
p Permit No.
Date P R' r —19— 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
City of Cupertino, and all other laws applicable thereto.
UsePre h i' _ t4 �� /�� Work To Be Performed '4-7z
OwnerG/¢_ ;� Wim" 3� Address ( al Ln .Y 6f�EadS' ��.f/yD� U/L
Phone_- 25-7- „1.S-7 ]--
By
ey Relco Electrical Conlructore, ing, Address
Contractor, Agent
Phone �a-6— 'P-0 �L 0 'e��
G10 259308
State License C-10
Electric Imp ctor
I AGREE I WILL NOT VIOLATE ANY OF THE WORT N'
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
0 L.
6
K
;I lk�
N 6
S
O.
d
LL
t
Y
2
C
6
`o
`o
`o
`a
n
F
`o
`o
Y
E
Y
Y
Y
Y
>
Y
>
2.
>
Z
>
Z
E
2.
o
s
w
in
Z
Z
;I lk�
N 6
S
O.
d
LL
t
LL
6