57230.2 Q NO. STR r,PT O LOT NO.
w eCITY OF CUPERTINO
o < , Yc. LICATION FOR ELECTRICAL PERMIT '►'
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n w Date 19 _ Permit No. 1 3 U, 2--
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a Fee $ �v
a AppGcatioQis hereby made to the City of Cupertino for a Permit to install electrical
r N wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
00 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
5 0City'of Cupertino, and all r laws appli thereto.
Use of Premis
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3 a Owner T Address --_
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� a EY Address —
Q O NT'RACTOR, AGENT Approved _
—U Phone: �,2 Ci S ' �� PP
LECrE1f,Ai INSPEC7M
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