NO PERMIT NUMBER _L/-2•3 (f.A4 L& X7,11 LOT NO. S / ✓
NO. STREET
an :P :X:'..1Bto CITY OFCUPERTINO
j UN 9 - IJr. gLICATION FOR ELECTRICAL PERMIT
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P ♦ ' f1 Permit No.
Date [ ,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 l,C�u/pertino,and all other laws applicable thereto.
Use ofPremises ^'«/�L� ���+'��� Performed
rfor Be �G�c�ifrc,�C
/? Performed /^
Owner he 7 d Tt 4 Addrecr l&f.rt0 .17 5 C`C.✓r0.✓ �{�,
Phone fJ�7-2 7Z' _
By Rdco Isleciric+d Contractors, Inc.Address f T f ';V 'e
Contractor,Apent
Phone ":t.;?4—'_24;z0
State License G10 259908 Approved
Electric Inspecfjr
I AGREE I WILL NOT VIOLATE ANY OF THE WOR N'S
Y, COMPENSATION LAWS OF THE STATE OF CALIFOR
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