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NO. STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
CITY OF CUPERTINO
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D Tob19� Permit No. p
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2 1//yy 963 Fee $
Application is hereby made to the City of Cupertino for a permit to install electrical
ga r fW d�n the reverse side hereof, and agrees to install said
g an�U7 r f s ' r ance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable ere
Use of Premi
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Owner ��/ _ Address
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170 Bou W ft�-oR, _ �@OX 921 ' -Approved
Phone: Mountain View, Calif. ELEcrarcaL WSPEaaa
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