2226 (4) OI r STREET� LOT NO.f✓IC D• /l ''
3
�I[PR ELECTRICAL PERMIT
+s ' JUI. 22 egg F CUPERTINO
tIi Date I r U p�(�195_ Permit No.
V . ERTINO Fee $ 717
Application is hereby made to the City of Cupertino for a permit td i4stall electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
4 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/"���n�LE
Owner/ 'Al/57/,v PGL Address/
By �� -4 L Address fO/V
CONTRACTOR, AGENT ,
Appro {�.
() Phone: ELECTRICAL INSPECTOR
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