1413 (2) NO: STREET LOT NO.
L I ELECTRICAL PERMIT
pi CUPERTINO
Date �f rVAY 11 1962 �I1
195_ Permit No.
(� T�/ /���p[pT Fee y `O o0 `
AppliXOI is h®Zy �6�tb R f 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, of er ws appli `' (recto.
Use of P
C
v '
;a Owner fq-VA n t" ress
i y _ Address
CONTRACTOR, AGENT
i
Phone: ^�6 UO Approve
ELECTRI L INSPE
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