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2472 (2) l
NO. STR LOT NO. ,
FA�PL'IC'A OR ELECTRICAL PERMIT
IOCT251963 ., OF CUPERTINO
Dater' `� iitlks 191k Permit No.
U Fee $ �_
'Application is hereby made to the City of Cupertino for a permit to install electrical-
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 other laws applicable thereto. -
Use of Premises
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a Owa je Address
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-cr$NT crcR, AGENT Approved
Phone: ��� 3 Y/ O ELECTRICAL niSpECrXM
1--77 Al
71,17
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