1731 �aqzgl (,AcL ( P- ) I (--), � 2� . ^y
NO., STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
CITY OF CUPERTINO
OP
Date ' 1 Permit No. I
1 , OCT 2 8 N2 Fee I °�
Application is hereby made to the City o Cupertino for a permit to install electrical
wiring and/������t��r 1H�j�1� the reverse side hereof, and agrees to install said
wiring andpriiltur�lin atcgt►fa rRTIN tore provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
v Use of Premi
c ,�
a Owner Address
By Address r
NTRACTOR, AGENT
Approve
Phony. UCER[UL [
NEW RPL FEES
Size Service Conduit......................Number of Outlets----------------- ..........L........
Size Service Wires................._......Number of Switches--- ------------ ----------
Size Service Switch........................Number 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--------..-----
Motors-------------------- HP-------------------- Phase----------------- Permit F $1.00
Motors------------------ HP----------- ---_... Phase----__..-------- H P jrg�------- --- -----------
TOTAL FEES
INSPECTI ROVALS
Rough Wiring/C��1�..�-.- . Fixtures -----------
•e oe Ix9�cCTOR
Finish Wiring ...... Motors -- -----------------1--
ocrc IMSPICTOR p_ xe "OR
oFinal --_- -------..-' >-- -.. -------'
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