2812NO. 'STREET LOT NO. --f---„-
AA5,1C FOR ELECTRICAL PERMIT
Dq�� c OF CUPERTINO
Dat ,j J �) 6 I r_ -Z.
PermitNo.
Fee S
)QTCYtiOQFhr RTQfQCity 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 Electrica(Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Premises
Owne 2?6�-e M.5 Address
By Lon Eala
y770 SiUP kki g¢roR, Addres
U Phone: 7_4iT'•"'�4`-'�3 Ar
k.r' State License: ,176 9 Y i
I