2822 (2) O. _ STREET LOT-NO.
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r oI FOR ELECTRICAL PERMIT
3 u D OF CUPERTINO
= a � JU1. 201964 �;
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)ate , 1 � Permit No.
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a N C�ppliafTdn is'heigf B del1[i�Yhe City of Cupertino for a permit to install electrical
awiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
50 City of Cupertino, and all other laws applicable thereto.
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z j Use of Premises
3 a Owner/`�q/ �O�'ry,/� p q Address � S—Ok F-0a I�VJ�oy
¢ a By 1�/t� 1�[Yi �f� G APA �� Y�m.a ddress e
O CONTRACTOR, AGE
a o 96?-y g 3 3 Approved
-0 Phone: EEECIAIUL rN5}RC701
ill-;_ State License: /7
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