1255/ NO. ,a 5 CE LOT NO.
PPLICA ONEORELECTRICAL PERMIT
DEC 12 b1C1 Y�OF CUPERTINO „
Date _ Q19,.Z Permit No.
Fee S per(,))de)
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
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
Owner
By Address
CONTRACTOR, AGENT
Approved
Phon ^ C[RIU[ INSPECTOR
Size Service Conduit..............__....Number. of Outlets -_...............
SizeS-rvice.Wires .........................Number of Switches ...............
Size Service Switch ................_......Number of Receptacles...........
NEW RPL FEES
------- 1111...
Size Sub Feed Conduit------------------ Number of Fixtures. .... .------------ I. --------- I.......
Size Sub Feed Wires ........ .----------- Ranges ---------------- KW ..............
Number of Circuits ------------------- Oven -.--------.-- KW ..............
Number of Meters ............
.----------- Signs ---------- Transformers....---- ----- ---
--------.....1111......
Misc.---...------...__----------------------
Dryers _......---------------............. - -1111_
---------
------------
Motors ........... -........
HP --------------------
Phase.................... Permit
Fee
$1.00
Motors---1`--------------
HP ....................
Phase ------------------
Motors-------------------
HP --------------------
Phase ----------------- H P Charge -------------_...-..........
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring ................
I ---------- ----------------- Fixtures ......................
L--- ----- ----------- ---
DATE
usfmroll DATE
ExvmTON
Finish Wiring................I-----------------------
OATE
Motors ---'--1111...
IMfr[OTOII //*P•ij,/
Final 1.=7..-a�'--'�
--- ----"--
aroN
--1111.----- '-
nlrt
..EIICTOR
1 / ELECTRIC SERVICE 'NOTICE OFFICE
,1 COPY
q6 BUILDING, INSPECTOR'S OFFICE
CITY OF CUPERTINO
O
........................ ........................ 196.1
To
You are hereby authorized to connect the ELECTRIC service for
Owner or Tenant .....
/—d(r
........... .......................
At ....x%7.20rte'�l!•/G�.�'
........................................................................
No. of Wires .....�
Motor Load
Heating Load
Size of Wires ...... ::.............. Size'of Switch .-..................
Voltage
K. W. .
Phase
Voltage
No. of Meters
Light ..............110 ..............New Service ...`........ _..... Reconnect ................
.............. !
Hnt .............
No. of Add. Me.220 .`..............Three Wire ..--..............More Service ..........
[en ...._....
Power .............. Three Phase ..................More Meter ............
................. .....
104 1/60-500 ELECTRICAL INSPECTOR ,