NO PERMIT NUMBER (5) 01117
N Q NO, 5rREET LOT NO.
x ° FOR ELECTRICAL PERMIT
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3 ® Y OF CUPERTINO
�oEe 2I 1970 �--
o Date
119 _ Permit No,
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Ice
awM /ctQFIs UFpY4CApTen /heCityof Cupertino fora permit �.
to install electrical
m s wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
00 wiring and/or fixtures in accordance ith the provisions of the Electrical Code of the
> N City Of Cupe d all other I. s applicable thereto. \
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BY Address
O F CONTRACTOR, AGENT
a o Y a53 —3028 APProv
_V Phonco !� ELECIRIGL INSPE
State License R% Aft
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