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IyO. st"K£ET LOT NO.
PI� . R ELECTRICAL PERMIT
CI F CUPERTINO P�N
Jur� 1 Q �ss2 Sa
Date TuN E / 1 194-2— Permit No.
CITY PE C9YERTINO Fees A 2,
Applica ion is PF ma a 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 Premi«e
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caner Address
B, FAQo Et&r'T Co Address a JA ' Tas6 <1-V yy
CONTRACTOR, AGENT S J
Approved
Phone: cY 2. C.33'/ E R. 11 mmECr02
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