2148 NO. STREET �� LOT NO. �.
D P7C�N 1 R ELECTRICAL PERMIT
N 24 1963CI�E.CUPERTINO
X11 JU
C Date CITY UF�� I't ilV 94 Permit No.
t� Fee $ /p(0 .3-5-
Application
SApplication is hereby made to the City of Cupertino for a permit to install electrical
Q 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
c ,
a Owner / Address ( ✓.
By e Address 7 O
CONTRACTOR, AGENT
/�� Approved _
/' Phone: .;%�L�'1'i 7 L/ ELEC[RP IMPECT03
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