877 �� I �e Crzes�rwua '� t
/O 1p _ sTAEET LOT NO. .
1 FOR ELECTRICAL PERMIT
TTY OF CUPERTINO
NOV 1 1960 4
Datej� , 195 k m Permit No.
CITY Of -CUPERTiNO Fee S
pplication is hereby made to the City of Cupertino for a permit to install electrical
as wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
Q 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 of Premi e Q
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a Owner Address
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CONTRACTOR, AGENT —?
Approved
(� Phone: � �-35(=o-2J ECT1ICA irw 0701
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