2826 NO. STREET LOT NO.
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x o1 FOR ELECTRICAL PERMIT
3 < D OF CUPERTINO
= LL ?1201964
JUL "� 7 r
, w Date 7� �3 , 14-L Permit No. 0-'—
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m a ece 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
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> m City of Cupertino, and all other lams applicable thereto.
oa
a_j Use of Premises
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3 a Owner qca¢.jD a Ss+� Address 82 01' led diV�
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LL CONTRACTOR, AGEN�
a U Phone: K;?-401),33 APProv RL-LTaruL cNseecemt
-V,.a State License:
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