51099.1 (2) ImedN NO.79 I STM89T a _' LOT NO. T I
4 FOR ELECTRICAL PERMIT
C a
3 V ® OF CUPERTINO
'S/OCT 291969 5i d
� o Date , 1! _ Permit Nw
$i !�/ Fee 5
�j� rptiis ei City of Cupertino for a permit to install electrical
:: wiring and/or fixtures as ist on the reverse side hereof, and agrees td install said
c `o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> ■ City of Cape 11 other laws applicable thereto.
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O Address; i Ow
WA., Address
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"7 CONTRACTOR, AGENT
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