2185 NO.
STREET � LOT NO.
i, PEL•IC4VIONFOR ELECTRICAL PERMIT
J U L ��� ITIY�OF CUPERTINO
1�5
Date n.�
_ t� Permit No. - rant
C- ; U C I n tt �y 4s
Fee ti
M 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
O City of Cupertino, and all other laws applicable thereto.
u
Ac
v Use of Premi 1�1
c
:a Owner 6�1 XCI I Address q G o CQL�— C
;9 By k 'r, Addres 1 ZC2J,
CONTRACTOR, AGENT
n Phone. 0'—OCDAppr EL¢C7R[ [. [rtSPeC7v7t
NEW EEL FEES
Size Service Conduit......................Number
Number of Outlets------------------ - - ----- - -- -- -C,
Size Service Wires------------------------- umber of Switches................ . .......... ... .....9
q
. 6
Size Service Switch........................Number of Receptacles............ .13 - -......... ..3.......
Size
-------- 13-------
Size Sub Feed Conduit.................Number of Fixtures------------------ -ev--- ---------- ---2.-�
Size Sub Feed Wires....................Ranges----/------- KW..............
Number of Circuits................... Oven _l-------. KW......_...... ..... .. .......... ..............
Number of Meters........................Signs.......... Transformers.......- ---------- ---------- ------yT
Misc......'---............................ D ers ---------- -----/-- ---------- --------------
--- ry ....
-- ------ -----
Motors------I/.......... HP--- Phase
Motors .. .............. HP.................... Phase---------- -------- 00
Motors-------------------- HP-------------------- Phase-------------------- H P Charge..............--I....../.GS
TOTAL
...../-TOTAL FEES
O OF INSPECTION ROVALS
Rough Wiring,/. .... .. ............ ........... Fixtur ..... ........ I-----.....-----------.----
0 INSPECTOR D. PECTOR
F __ . f Sq .. I.. .... ..... ....................
Finish Wiring .............. ........... — ..- Motors I
PATE IN PECTOR SP GTOR
.. ....... ............. ----------
Final .9—
VATS INSPECTOR
O ICE COPY -
ELECTRIC SERVICE NOTICE
�� BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
TO
You are hereby authorized to ne electric e ' e for
Owner or Tenant .-- ----...--`--- ------.....- -- -------
i
At ...... .�.,i... ------------- --------
I
No. of Wires ........ .......
..... .... Size of Wires .............7,/. Sizee of Switch I-.0�.
Motor Load .......................... Voltage ----..----------------------- Phase _-----.......-----
Heating Load ..............-........ K. W/.... -------....-- Voltage
No.
'''`..............---.......
1 Light...it. 11. 0..... 1 New Service.. _
............ Reconnect.... ............
No. of Meters.................
Heat......y./.._�220._y/Three it ... ..-. .... Move Service............
No.of Add.Meters............
Power.............. T e ----- . .. Move M r..............
104 1/63-500 ELECTM L INsrac R