1530 (2) /G' 2
NO. - STREET ' LOT NO.
A IG TION FOR ELECTRICAL PERMIT
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OF CUPERTINO
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Da c ! . 194 Permit No.
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/�A ppLication'isthereby'made(to7the Cityof Cupertino for a permit to install electrical
43 wiring andJor f 5A',9"as Psted`on the reverse side hereof, and agrees to install said',. _
wiring and/or fixtures in accordance wi the ns•of4deiElAttrical Code of the
Cary of Cupertino, and all other lags applicable thereto.
H Use of Premise<
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CONT C`MR, AGENT Approved
j Phone: G'' /7� Sf��l�' PP
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