1005 103
NO. STREET LOT NO. ,
10 tfI6
ECTRICAL PERMIT r
ERTINO
7 /MAR Q 1 00;
Date �/ /7 6/A
Z U Permit No.
nF (�''❑ pT Fee S I / L4,Applicati'n is h�f�by �e�t R f 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.
v Use of Premia
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Owner � Address
ti By Address
CONTRACTOR, AGENT
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