1903 (2) NO. STREET LOT NO. y�
J l; ELECTRICAL PERMIT
F B 4 9 Cl F CUPERTINO
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Date f /-z 19ta Permit No. �Z/4)J
CITY OF. CUPERTINO Fee $ 0-15-
Application is hereby made to the 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
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:a Owner 'LZ Address
y By Addreess
Approved
CZ CONTRACTOR, AGENT A / •fir
Phone: ,QL-3•G< G EZE UL mpEcroa
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ate License
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