1780 NO. STREET 107 NO.
rfkF RELECTRICAL PERMIT
CUPERTINO
OV 21h
rDate �• 0 2— Permit No. w
V CITY �;�IY«Klil`� Fee S s�D
Application is hereby made to the City of Cupertino for a permit to instalrelectrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
N wiring and/or fixtures in accordance with the provisions of the Electrical Code of th
�O City of Cupertino, and all other lIsapplill thereto.
Use of Prem'
.7 Owner 67144& Address
By ::,:Addressi
( CTOR, AGENT t Approved
Phone: 4)K 6 Sp Z O 4, E.....GL pJsyp(,yps i
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1-4-15
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