844 STA _ LOT NO.
'PPL7C`A R ELECTRICAL PERMIT
SEP 27 1960 OF CUPERTINO
VIj
DatPermit No. 7 /
U11 I U1 WFEMINFee 5
Application is hereby made to the City of Cupertino for a permit to install electrical
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.
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J Use of Premi
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a Owner Address
By A Address
C TR(ACTOpp(RR, AGENT Approved
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Phone: L 2 I { E, LF�GTRICAL INSPEC70i
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T., •the uridcrsigned'Sc.hereby certify that
the ovme'r and occupant of the single family 'dwelling at
for h.I^•:ar, making -
application to do / jtaork as a home ovmer.
I also certify that I''will "not hire any non-licensed_
i/ f/or 'contractor, but will do this wort. mysEl£.: ,
TELEPHONE 1,M BER SIGNATURE