2331 /rte 3' . % h.esQQ C.�.
NO.� STREET LOT NO. e1
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APPLICATIO Ni ELECTRICAL PERMIT
v7r� ;;CITY Or CUPERTINO
Date -- , 195— Permit No.
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
U wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
O City of Cupertino, and all other laws applicable thereto.
v Use of Premiseq
V
iAddress 1 /�,r.g .�Ca.oy�.Address
;.a Own(/dr Bte�-r� e
By kl,," £ (—A0Address
ONTRACTOR, AGENT
Approve
p
Photic: 7 /— Yf 7 ELECTRICAL INSPECTOR
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NET RPL _ FEES
Size Service Conduit :.. .
ci. _��....Number of Outlets.................. .�...`�. ._..... `
Size Service Wires.._....X.............Number of Switches................ O
.'... ._......,�a:..y._...
Size Service Switch ..=.L.4.O......Number of Receptacles.......... . -------.
.........- - _57
.....
Size Sub Feed Conduit._............._Number of Fixtures------------------ :;)Z .......... �..t.y
Size Sub Feed Wires......._.....-----Ranges..... KW.-2:.g_. _ac.. ....---.. ).:.5�.
Number of Circuits...!.5 ....... Oven ....... KW.3.:.g.... .. .... .......... .(----S�
Number of Meters----P..
.................Signs.......... Transformers......_ ...
Misc---------' ----- Dryers------I-------------------
Motors---
----Motors._ ............. HP F,,t&A;�"a PhasePermit Fee $1.00
Motors ------ HP------------------ Phase------------------
Motors HP Phase H P Charge....--------- !'-,Sb.
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TOTAL FEES
C �� RECOR OF INSPECTION APPROVALS
Rough Wiring Li I'-V�d.S..-l_...-----. Fixtures .-------'-----... -------------------------
DATE / INSPECTOR DATE INSPECTOR
Finish Wiring ....I..............----...... Motors ......------. .......... .._---.......---...... --'
---.
DATE Ixsr[croR
GATE IN9P[CTOR
Final -------------'-----.......�"---........---......----'
DATE INSPECTOR
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