51189 (10) 'O. STREET LOTIP
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N Q
APP ICAT O FOR ELECTRICAL PER
y O A
o a f;1'j I OF CUPERTINO
969 /� 1
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o Date , 195 Permit No.
a
Fee 3 s�ZO
a w Apply�gi�f i�h�re UPERTlRGY of Cupertino fora permit t msrt/all electrical
W i wiring an
fixtures as listed on the reverse side hereof, and agrees to install said
W
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
5 City of Cupertino, and all other laws applicable thereto.
03
oa
z_j Use of Premises
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O 7'
F Owner Address
— N A
w w By _ Address
rc n CONTRA T R, AGENT
a o Approve
—� Phone: _� eLECCAIrAL INsre
State License, /J —— 4� (/
NEW RPL'-' FEES
.............
Size Service Conduit.........`..::.:::::.::Number of Outlers---------------- ---------
Size Service Wires.........................Number of Switches................
Size Service Switch........................Number of Receptacles------------ ---------- ---------- . ......
Size Sub Feed Conduit..._.............Number ofF' tures......------------ AY- --------- ....�-qjq.
Size Sub Feed Wires-------------------Ranges....... ...... KW.............. ... .. . -------- ---
Number of Circuits................... Oven .............. KW-------------- - q,10
2
---7- - -- ------ --/---------
Number of Meters------------------------Signs.......... Transformers........ .. ....... .......... ..............
-F Misc......�. 31,0...!e--xl!�V- --4---------Dryers............. ..... -------------------- ---------- -------------ZST
Motors-------------------- HP-------------------- Phase--------------------
Motors-------------------- HP-------------------- Phase-------------------- Permit Fee $1.00
Motors.................... HP-------------------- Phase-------------------- H P Charge---------------- -----
TOTAL ;ZZ10
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- ---------------------------- Fixtures ----------- .......... ------------'---'---.-------
DATE I"S PEc... DATE INSPECTOR
Finish Wiring ................ ................ ....... Motors ----......... ........-I---------......----.....--
............ ......-I----------------------
DATE INSPECTOR DATE INSPECTOR.. ..
Final .. . ...................
11 DATE INSPECTOR