2565NO. '" STREET LOT NO. /07
I OR ELECTRICAL PERMIT
® OF' CUPERTINO
N 22 1864
Date / T 195— Permit No.
CITY OF CUPERTINO Fee s /3 �S
App kation 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.
Use of
Address
Address
�C T(RAACTOR, AGENT Approved SN
Phone: 0? T—Ty��� ELECTRICAL INSPECTOR
6 State License:/6 yO�z
)
ol 0
}
\
}
\
/
) �.::
\
\Z
620
Z
(;5