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NO. sTRESLOT NO.
1: ELECTRICAL PERMIT
fr"JUN 14 1W ill, RTINO P`A,y -T01
Date Y Or, /CUPER lV Permit No. / Z
ItlV Fee S q `�C-'
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 Premi«<
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Owner 6 L'V E'2 ROu 5 A hF/? U Address
By 0=4*0 6-7-6-4'r CO Address 0 5 n, JosE Av g�
CONTRACTOR, AGENT
Approved � '
Phone: Cy � � O � � E_ eracuc nvsee
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