2723 pZ02L) (V) C <'_ Iollr: rt f'��1 .
NO. STRUT LOT NO.
Y o APPLICATION FOR ELECTRICAL PERMIT
2 _
o � � or cuPr_Rrlrao
$ u
o
Date 195_ Permit No. -
Fce
q A c ier �Yli�City of Cupertino for a permit to install electrical
w it , ,yld ,,..
? wiri i o xtu s 1 ed on the reverse side hereof, and agrees to install said
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> m City of Cupertino, and ill other lagsappFeable thereto.
o J Use of Premises L ��� J rr`Q C-LP, w3etQ
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J O
3 a Owner \/A_.. _�Address
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w Z
W w BY Address �
R d
u s CONTRACTOR,
coNrrtncroa, ncervr
a o Approved I/ . l y /L
z
—U Phnne: !`
State License, LeerniucrNs►eCZol
NEW RPL FF.ES
Size Service Conduit.-..--.--_-..----....Number of Outlets..........-':..'. :. .'--
. ..... ..... ---- --------- -
Size Service Wires------------------- _Numbr of Switches.....---..-.---- ---------- ---------- ..............
Size Service Switch---_................._Number of Receptacles-...-._---- ---------- ----- --------------
Size Sub Feed Conduit------------------Number of Fixtures_---------------- ---------- ---------- --------------
Size Sub Feed Wires----------------- Ranges................ KW------------- ---------- ----- - - --------------
Number
-- - --------
Number of Circuits-------------- --- Oven .............. KW-------..... .......... ...... --------------
Number of M16-Is— --------------Signs.......... Transformers__-- ---------- - ---- --------------
!��Q - , , (
Misc.---------- :—firy_e,r .....
-- ---------- ---------- ` . ------
Motors......._-..........
- - ------
Motors......... .......... HP.............. --- Phase...._..._ Permit Fee $1.00
Motors.-..--._-..--_. HP---.._.-------.- Phase.....------.....-
Motors----- -------------- HP-------- ----------- Phase-----------_- - F1 P Charge.---...------ ^-------
TOTAL
harge---------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring--------------- I------------------- -------- Fixtures -------
_ __
�;.CTOI -
Finish Wiring .....D---A V K----- ------------ Moto"
Final
DST
1111.cTOR
OFFICE COPT'
ELECTRIC SERVICEONCE -
�� BUILDING INSPECTOR'S OFFICE
1_ Q CITY OF CUPERTINO pp
ae Q'v'P� 4 & .1 .... ......., 19 ...
4 tCe f....__..._............ . . .....
cJ� You are hereby ut'orized to conned ledrical service for
Owner or Tenant �1 -�
-.........QF.,. irv......................._...... ....
. . . .......................
No. of Wires _.. .............. Size of Wires --------- Size of Switch'.�.d
Motor Load .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. - ........._............. Voltage ..... ..........................
No. of Meters. (Light..__... ✓...
110... .... New Service....DOW. .. Reconnect.............._..
......�......... 1 ,1
Heat......:�.�...... 220...Y...... 1' ree Wire._.........._. Move Service%__.
No. of Add.Met.ers............ ( t
Power............._ ��'���yyy ee has e....._.......- Move Meter..............
104 7/63-500 ELECTRICAL I SP CTO