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NO. STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
y& ZI F CUPERTINO
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Date 5_ Permit No.
Fee S /�r��
Application is hereby of Cupertino for a permit tom tall electrical
wiring afN, reverse side hereof, and agrees to install said
wiring an 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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Owne ,� "7 Address
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ONTRACTORAGENT ApplOvse
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