1782 10 3 t Z ( ale,
-h0. _ STREET 0 LOT NO.
AMCELECTRICAL PERMIT
�-'�`�' OF CUPERnNO
9
Date a t/ry• , 195cz- Permit No. / `78
-L,
91lto4-:;3-��,a-, Fee
Application.is herebymade 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 e
City of Cupertino, and all other laws applicable thereto.
Use of Premise
c -lf
a Owner �' / �` Address
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J -�Q ItACPOR, AGENT
r w"— Approv
Phone: 4 X 6 5A-7-0 CPRIUL WSPECTM
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