602 NO. STREET LOT NO. ,
APPLICATIONvFOR ELECTRICAL PERMIT
Aft CITY OF CUPERTINO
Date Z 195_ Permit No. ✓�
Fee S a
Application is hereby made to the City of Cupertino for a permit to install electrical
wiring V75,11 1' tuv��a�s lj'igr?dlpt1(�he reverse side hereof, and agrees to install said
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wiring andyor fixtures in accordant with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
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a Owner r•'•'� ,Address
'*Address
ON CTOR, AGENT
_ Approved
Phone: 4rbICAL INSEECr M
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