2684 N ¢
NO. T LOT NO.
0 OR ELECTRICAL PERMIT
Y 0
3 < APR 13 1964 OF CUPERTINO
u
i o ��Da� 6 I thin 195— Permit No.
'0 111 V
a Fee 5
a m Application is hereby made to the City of Cupertino for a permit to install electrical
W = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
o 'o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
S W City of Cupertino, other laws applicable thereto.
z-1 Use of Premises _ e^v
J Z
J O
a Own Addres
N
W w _ Addrest co ACTOR, AGENT f ~
a U Yi ?� Approv
Phone: UL INSP8C791
State License: 60�
v
v
K YE
v x 6 w
o FO G i
00oa � vvv W
z z z z a o N q w
o
: xxx
Q�
LID
V_ V_ U [L W � WO 'y •a
0 0 o m
�n �n in in iA 0
z z �4