1648 LOT NO. �
APPLICATION FOR ELECTRICAL PERMIT
- CITY
18 Wx?z o�uPERTINO
Date
CI Y Of nimf� YY"t� Permit No. / O
(� ^� Fee
�p 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 n all 0-her las �4I 1e thereto.
yTTqo of Premi \�A4///
c
V
a Own6C�cldress
By _ Addres
9 G cw ins irate
CONTRACTOR, AGE
X 377-428p APProved '
Phone: LEC R CAL INSPEM
NEW RPL FEES
Size Service Conduit----------------------Number-of Outlets ----- -.---------
Size Service Wires------- --5--------`7iNumber of Switches-- --.......L.............
Size Service Switch----16 6../5Number of Receptacles._.:_...... ........_ .
Size Sub Feed Conduit-----------------Number of Fixtures........::........ ...
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
RECORD OF INSPECTION APPROVALS
RoughWiring................ ---------------------------- Fixtures ------------------- --- ---- -------...------
01 TE 1116.__ DATE IKSPECTOR
Finish Wiring ................ --------............... Motors ... -- -- � --- --
DATE 166TECTUR
Final --r/ —-----�---- -- ------------- -
.AT IX{TECTOR -
— � k
ELECTRIC SERVILN.QTICE
cnPr
HUILDING INSPECTOR " OFFICE
CITY OF CUPERTINO
..`.. is jo You are hereby,aut ¢ed to tonne ie �CTRIC servi r
Owner or Tenant . . . .. .---- .. �..._....-............. .... .-- -- ...... �....�...L.d.�.
At ......._........ _..........................
No. of Wires ...... Size of \Vires .#.._Z...
_ .._ Size of Switch .� �� P11..... ..... ..
Motor Load ............._........_ Voltage ..-----.................._.... Phase -,.........................
HeatingLoad ... K. W. g ��++
_._... ....._-... - Voltage _ -.........
lLight _-_t-- ....110 ...............New Service _ __.Reconnect ................
No. of Meters..._'............. Heat ..... 20 ......._.... hree Wre........__..__Move
No. of Add. Tfeters .......... Power .........._... Thrcc hale
.L..1._.._..._.Dlove(hnJ(eter ............
GLP.CTRICAL IN LTOR
104 7/61"500 l.J