2280 NO:: STREET
�� STAEET LOT NO. ,
APPLICATION FOR ELECTRICAL PERMIT
CITY OF CUPERTINO
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Date 1195-- Permit No. c;2.,?—�
c Fee
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
bwiring and/or fixtures in accordance with the provisions of the Electrical Code of the
0 City of Cupertino, and all other laws applicable thereto.
Use of Premises
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CONTRACTOR, AGENT Appr ..
Phone: GL @75PHC701
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