2813 NO. STREET LOT NO. .
R(JTJAMUFOR ELECTRICAL PERMIT
UL 13 1964 TY OF CUPERTINO
b1d Iau , 19� Permit No.
Fee
Application is hereby made to the City of Cupertino for a permit to install electrical
O 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 the
City of Cupertino, and all other laws applicable thereto.
v Use of Premi
CP.I� ; !�
:a Owner Address
9 By J. l Address J.
1n TO South Afois F?R,ftE18DX 921 Approved
Phone: L 'j"' ` is ELECTRICAL RISPECTOM � '
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