2686 /03/5/ Ir'70'`e wa�
NO. STREET LOT NO.
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�OELECTRICAL PERMIT.
oC TY :OF CUPERTlf70
14 1964
W LL . /
I O U�//C/^
n r Date 195— Permit No. _
° = CITY OF CUPERTINO Fee 5p� �5
a m Application is hereby made to the City of Cupertino for a permit to ins Call electrical
W I 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
5 w City of Cupertino, an 1/other laws applical l� thereto.
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CONTACTOR r nE PProv da o X
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_U Phone: ELECTRICAL INS00.
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