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51234No. Street Lot No. E.. CF,Cyp: APPLICATION FOR ELECTRICAL PERMIT CITY OF CUPERTINO9%j e 1967� Per mi[No. jz�j3 � Fee $ ( r s oo 3 � Application is herc`6ry made to the City of Cupertino for a permit to install electrical wiring =' v and/or fixtures as listed on the reverse side hereof, and agrees to' stall said wiring and/or o fixtures in accordance with the provisions of the Electrical Code of [ e ity of Cupertino, and ° all other laws applicable thereto. ``• c ti Use of Premissees/ t `e xi 3 Owner ��l1�iy /G Address /e�lg INO ELECTRIC. TNC. ° By Address act EvelyabntkaFMtAgent Approve �;t, vale California 94C86 � E it �rt� Electrical l pec[or " u Stale License Go 1;;r 3J ITEM I NEW JRPL IFEES Number of Outlets Number of of Power Poles