1669 20104 I LaRoda Ct.
NO. STREET LOT NO.
n R ELECTRICAL PERMIT
Y C F CUPERTINO
f SEP 201962
Date 9-1919 62 Permit No. o
CITY OF CUPERTINO Fee ?
N Application is Hereby made to the City of Cupertino for a permit to install electrical
N 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.
residence ` . .
Use of Premia
V
C. 0. Lindsey as above ;<• f '-
a Owner Address
By H r i. PRF Address �'r•.<r'!
h CONTRACTOR, AGENT
Approved
Phone: E ECMCAL INSPECim
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