1889 1 WcCl2IIn,J
NO. STREET LOT NO.
��E, D
F'ri-Na-FOZ �t ELECTRICAL PERMIT
FEB ITL CUPLRTINO
7 'J9S�
Date —Y OF 1]y5_ Permit No.
I'VV Pee S �sO
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 Cupertin other laws ap llii(y�J��1/�)thereto.
u Use of Prem
c
Owner �g � �/ b�� Address
By, AddreX
CONTRACTOR, AGENTQD
f ^ ,f Approve
Phone: �� 9 '2Z X(] ELECTRICAL INSHH(.TO;
NEW RPL FEES
Size Service Cenduit----------------------Number of Outlets-o........ ..... .......... ....... ..I._.-.....
.---
Size Service Wires-------------------------Number of Switches,. ----.------... --------- ----------
L....-----.-.
Size Service Switch........................Number of Receptacles......------ --------- ---------- -------------
Size Sub Feed Conduit------------------Number of Fixtures.._........._..- ---------- ---------- --------------
Size Sub Feed Wires---------------.....Ranges................ KW....------- ------- --------- ------------
li Number of Circuits------------------- Oven -------------- KW-------------- ---------- ------- ------------
Nurr�er f Meters..�....�q_. .....Signs.---...... Transformers-----.- -------- ---......
- .............
s ------------ _-------- ------- -------- - ---_... �0
Motors............ ....... HP.-. . Phase.----------._.-. Permit Fee $1.00
Motors---`--`..--------- HP-------------------- Phase...---------.....---
Motors-------------------- HP------------------ Phase-------------------- H P Charge..... .aO-
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring----------------I---------------------------- Fixtures ------------------... - -----...- ------------
DATS INSPECTOR DATE INSPECTOR
-----.....-'--�---
Final Motors ---------- -------�'- -- -
oArE Ixe PeCTOR R
Finish Wiring .
/� �u .......
n:�1..:�
DATE INSPECTOR
I
OFFICE COPY
ELECTRIC SERVI -E NOTICE
BUILDING CPEINSPECTOR' OFFICE
CF!
CITY OP�C tPERTI O
-------- ........ . -- 196
To j
You are hereby autho Conner el serv' e�or
Owner r enant
i
.At
No. of Wires ...-------------- Size of Wires ....._... Size of Switch
_.
Motor Load - -----..--------........ Voltage ----._.---- Phase
HeatingLoad .. ................... K. W. ......-...----------- .... -- .. Voltage
No. of Meters......-----.. Light................ Ilo..._4.......- New Servicn_� .... Keconnect.......
Heat.........._.._ 220 . Three Wire..._......._.. Move Service..
No. of Add. Meters............
Power....._......_ _..__...... . Move Meter..............
1041/63-500 ELECTRICAL INSPECTOR