2283 NO. STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
V CITY OF CUP.ERTINO
Date _ 195— Permit No. .
3
Fee
t Q Application is hereby made to the City of Cupertino for a permit o install electrical -
t wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said -
Lwiring 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 Premi
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:a Owner G Address �� '`�8�' gZk4 id.�c..,.o
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By Add��
CONTRACTOR, AGENT APP°`
(� Pho.E: -3'19 ELECTRI L INSPHCTOl
• NEW RPL FEES P
Size Service Conduit.cL&/--------Number of Outlets._............... r�Z.`. ........
Size Service Wires.�....2..............Number of Switches.._.........._ -.- ----- .........I....
__ _O
Size Service Switch.a.:..L!2-0----Number of Receptacles............ 5�.. _..___ ..............
Size Sub Feed Conduit..................Number of Fixtures............------ .�'2...`.5Z.. .......... a: -/c,
Size Sub Feed Wires--------------------Ranges....2-------- KW...Z-..Y.. ..> ... ----- --------------a
Number of Circuits.... .......----- Oven ....--`---... KW2j:.3.... ----..-.. .......... . `sv
Number of Meters....;.?r---------------Signs.......... Transformers........ .......... .......... ............--
Misc........... .......-.....-- Dryers------I........---..---
*-- _.
.----
---- -_�---- --------- -----3
Motors---- -------..... HP EPA�Phase.Z-5er..-2-[.---
Motors--------------._. HP-------`---------- Phase......... ........ Permit Fee $1.00
Motors...........-....... HP----------------- Phase-------------- ----- H P Charge------------ --
TOTAL FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring................. ---------------------------- Fixtures ------------------
DATE INSPECTOR DATE SP CTOR
Finish Wiring ................L.------.......--..... Motors --- .....
PATE INSPECTOR q.TE 2 IN [CTOR
Final t.-----. 1J- ......-
DATE .INSP[CTOR
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OFFICE COPY '� e
ELECTRIC SERVICE-NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
To 11
You are hereby aut odjzed to connect electrical jcq for
1 1
Owner or Tenant -..........:e.........,�.:+.%...�..-.:y.Nti.�... ... S,.'w;r..�� .L1.�- ..-----....
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No. of Wires ......... ........ Size of Wires ..........Y.:...... Size of Si
er`. ......._.._...,�
Motor Load ........................... Voltage ............................... Phase ...._ .................
HeatingLoad ........................ K. W. ---------------------------------- Voltage ...............
/��/...... LightL.�.
110......... `New service_� ... Reconnect._............... . .
No. of Meters......,/
Heat..... ..... 220....... - Wir^........ .. Move Service............
No. of Add. Meters............ 1d.
Power.............. "➢brae Ph Move Move Meter,.............
1041/63-500 F.=RICAL INSPECTOR -;'-