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NO.. STREET <.�.. .. LOT NO.
o AflRL1[CATIQ rF0R €LECTRICAL PERMIT
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o Dale 195— Permit No.
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;arw Application is hereby made o the of Cupertino for a permit to i stall electrical
:w wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
o `o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
m City of Cupertino, and all other laws applicable thereto.
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` 3a XOwner pIZZINO Address 10370 IUORwser-\
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CONTRACTOR, AGENT _
'. ao Approved
-u < Phone: Z4 s=//µ.4. 4 yy�77 ELECTRICAL INSPECTD;
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