1395 (2) 30o
NO. STREETLOT NO. �•
// D
APPL TI FOR ELECTRICAL PER ,
Tf'MAY
4X%=zCUPERTiNO
Date 7 1962 'S_ Permit No.
1 Fee
Appl%fyis6eb tR�ii of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on t e 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.
s, Use of Premi _
u
;a Owner Address /J
IB 0 Addr
, ONTRACfOR, AGENT
p s— Approved
Phone: [� 3 C,�
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