2200 NO. STREEW LOT NO.
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G�4 �R ELECTRICAL PERMIT
� C ' F'CUPERTINO
16 9963Date qr��pF T n,, 195LI Permit No. G
tb O tr'y`hi ilP�d Pe'C Fee ti ta
Ap i n � ere a e 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.
Use of Premises 41 P
a Owner Address
v
ro By Addres
CONTRACTOR, AGENT
�i Approved
Q Phone: .2-.rk 3'79 Z— ELECTRICAL INSPECTOR
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