1455 vleKs OuRG DAR /vc _ 2'1 c
NO. �71tEET LOT NO.
PLAM PL � 1 FOR ELECTRICAL PERMIT
CUPERTINO tPLaJn ' 50/-44
Date �J62 9b Z Permit No.
�,T� }� Fee $
AppliCt-Tryis ()FbyojpgTl of Cupertino for a permit to insta electrical
wiring and/or fixtures as liste on t reverse side hereof, and agrees to install said
wiring arid/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Premisee / %-AM
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V caner �LryE2 rt'ou 5 S c--.q L/ Address
By �NQo EL6cT c o Address Z i • 4 To3F 44W
CONTRACTOR, AGENT
C 2 - 0 3 S/ Approved
Phone: y ELECTRICAL ff SPECroa
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