2115 Qwu
NO. STREET LOT NO. -_
31M, T�D
VULOJUN
PPLICATION FOR ELECTRICAL PERMIT
ITY�OP CUPERTINO
21 196 e_'_.� � �5�
Date 19 Permit No. - -
G' ;Y Ur U1.1YL 1 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
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all oth .ws applicable thereto.
V1 Use of premise,
c ��V
v
a Owner ddress �
By Address ).
ONTRACTOR, AGENT
APProve
1°1 nmc: ELECTRICAL INSPECIO;
NEW RPL FrEs
Size Service Conduit---r.._.............Number of Outlets._..._..._.----- -V---- - -------- -.2y....
........
Size Service Wires.__............._......Number of Switches........ .... -- ---------- "?
R
Size Service'Switch........................Number of Receptacles------------ - .. ..... .... . ---------
Size Sub Feed Conduit------------------Number of Fixtures-------------- Ill---.. ._....... -------------
Size Sub Feed Wires....................Ranges-----J-------- KW-------------- ---------- ---------- ----
Number of Circuits.-.------------- Oven ---/....... KW.............. .......— ---------- ----
Number of Meters........................Signs.......... Transformers........ ---------- ---------- --------------
Mi5c------------ ------------- ---------------------Dryers -*----/ * ------------- -------- ----- --- -----7.5-�
Motors... -------- HP----- Phase 0--- -
Motors...I..--------.----
--- ---------- HP................... Phase--------------------
Permit Fee $1.00
Motors-------------------- HP.................... Phase-------------------- H P Charge----------------
Ir/y ES
TOTAL FEES-------
RECO
�R�013` INSPECTION APPROVZS
RooghWiring,6
... ....qQ... ......... Fixtures
-
p Tbll,
Finish Wiring ...... , /._------
I Motors ----
DATE IA
PE To. I
Final
----------"---- - -.._......
DATE
-------------------
DATE
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
To
You are hereby authori d to connect el
Yrica�Vemce for
Owner or Tenant ----
------------ ----------------
At
--- .......
No. of Wires -------------- Size of Wires' ------ ---- size of Switch/00.,f...
Motor Load - --------------------— Voltage - --------- ----------------- Phase
Heating Load ------------------------ K. W. .._.---------- --- -----. - Voltage ........ ......... .......
No. of Meters --------- New Service...:n-- Reconnect-----------------
e 220....... Three Wire..._._....--.. Move service.
No.of Add. Meters..-.-....... ........
Power.............. .............. Move Meter..._....._..
----- ------------------------
104 1/63.500 ELECTRICAL INSPECTOR