2061 /� I T
ND. � ST LOT NO. ,
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ELECTRICAL PERMIT
/ OE CUPERTINO
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Date , 19 �s.J Permit No. "
CTX OF . YPERTINO Fee S
App ication is here y made to the City of Cupertino for a permit to install electrical
l� 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.
Use of Premises
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Owner �in+'-=`�j� w�t1 it"rG,•rI�i.�.f.. Address
By Address
CONTRACTOR, AGENT {
�.�/--? O Approved
Phone: LEMUCAL DWECTOR \ /
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