1970 NO. STREET LOT NO.
, 1 I FOR ELECTRICAL PERMIT
AITY OF CUPERTINO
ivAR 2 �
Date 195_ Permit No.
CITY OF CUPERTINO Fee d
Application is hereby made to the City of Cupertino for a permit o install electrical
M wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all er laws applicable thereto.
a
Use of Prem' ✓
� Owne _ Address
By Address
CONTRACTOR, AGENT Approved
Phone: 3 7�^ e 73 Z ' CTa[UL ¢1SrR(.'ms
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