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CITY OF CUPERTINO
AYR (ABPISdATION FOR ELECTRICAL PERMIT
Date 3 �P tq_
Permit No.
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Application
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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 Cade of the
City of Cupertino, and all other Idws applicable thereto.
UN of
Phone -Z-5 3 ` 7dj--0
Work To Be
B�L�z�iirfAyJ �� J i X64 Address r/.�o I'.
rr- Contractor,Agent
Phone 3 7S- — /4 5'2 ys 7a ff
State License zZ ` 2 j ICE Approv
Ele ric IInspector
I AGREE I WILL NOT VIOLATE ANY OF THE WO N'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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