1234 NO. STREET LOT NO.
ELECTRICAL PERMIT.:
CUPERTINO
� NOV 15 196fi
Date l7 6✓. �� , 19 Permit No.
CITY OF CUPERTINO gees f4 �°
Application is hereby 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
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
m Use of Premises
c /� n
Owner` �••a Lwe,('z(� Co�Address
By Address
CONTRACTOR, AGENT
Approved
Z5�11 �-
*L: L' "2 ��?z ELECTRICAL IMPECOTM
.4i g i
04:
AS
0
ull
014 P� C11
0 0 lE
2
Pq 14
Z ¥2 >
p p 7
\ (
0
/ / \ \ �� � y q
02
W-M
rA
m } � : \ \ 5 �
ml
t,
\ ° & R