1736 IJO. STREET LOT NO.
OR ELECTRICAL PERMIT
1 OF CUPERTINO
Date ' 195— Permit No.
d �F gUP;RTINO Fee $ S�
A on here y ma a to the City of Cupertino for a permit to install electrical
wiring andyor fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures-in accord ncc with the pr . ' of the Electrical Code of the
City of CupertinoAnd all o` er laws applica le therreett F
Use of Premi—
a Owner Address L-6.4it Sa
;g By Address
CONTRACTOR, AGENT Approved
Phone: S bS1 ELECTRICAL ENSPECTM
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