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/ PPLI�A i0RF ELECTRICAL PERMIT
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o Date f 195— permit No.
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a Application is hereby made to the City of Cupertino for a permit to install electrical
m i wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
00 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
S 0 City of Cupertino, a I other laws applicable thereto.
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QO CC,/T(RRAACTOR, AGENT Approved — /r
_U Phone: / 1"/�� y ELECTRICAL INSPEC701
State License:
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