1488 o26 7�5'7 mit e f ImAl ,CcC
No. LOT TPI2O�F i ELECTRICAL NO.
Y JUL 2 196Fn CUPLRTINO
DateN¢4�' Permit No.
C L Fee S
Applicat n is hereby made to the City of Cupertino for a permit to install electrical
.4 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.
s, Use of Premises �GJ
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a ner
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P/ one: _ ELECI]UGAL INi►ECIOl
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NEW RPL FEES
Size Service Conduit......................Number of Outlets------------------ ---------- ----------
I---
....-----
.-
Size Service Wires_----------------------- of Switches---------------- --------- .
Size Service Switch------------------------Number of Receptacles............ _._..22... .......... ..-----.----
Size Sub Feed Conduit................_Number of Fixtures.................. 12— ---------- --/,;-?.P
Size Sub Feed Wires--------------------Ranges---------------- KW-------------- -------- -------- -----------
Number of Circuits--'-------'-----` Oven ------------- KW------------ --------- -.... ..._.......--
Number of Meters........................Signs.......... Transformers........ -------- -----...- -------------
Misc-----------------------!------------------------Dryers------------------------------------- -------- -------. .._.._..----
Motors...----.-.-------- HP--------- ---------- Phase-------------------- Permit Fee $1.00
Motors------------------- HP------------------- Phase..--------......
Motors----- ----------- HP------------------ . Phase----------------- .. H P Charge-------.... ...
TOTAL FEES oZ�a
RECORD OF INSPECTION APPROVALS
RoughWiring----------------I---------------------------- Fixtures ----------------------I--------------------`----
D.1TE IH]IECTOR DATE Ix]r CCTOR
Finish Wiring L...-------------------- Motors --------- ----- I -----'--R CT
----
D�T ixa �r[ oR
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Final 771 --'----
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