1442 �l—A�4,Pa�'r sT
NO. STRL ET {� LOT NO.
sAPPLICATION F - At ELECTRICAL PERMIT
f JUN 11 19620 �F CUPERTINO
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e
Date 07,j rAi 1,19 Permit No.
41 I 1 U
I=ce �+
Application is hereby made to the City of Cupertino for a permit t 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, and all other laws applicable thereto.
J Use of -�ieC�� C'
C
V
+t Owner ddress
t
syAddress
CONTRACTOR, AGENT
Approved
Phone: — — E ECnsrCAL wsPecr=
NEW RPL FEES
aa
Size Service Conduit----------............Number of Outlets.................. .. ------ ... .... SJ
Size Service Wires-------------------------Number of Switches.......-------- - - ----- ---------- - ---....--n
Size Service Switch........................Number of Receptacles............ .4---- ---.------ .....t.�fl.
Size Sub Feed Conduit------------------Number of Fixtures.................. le. -..------- -----
Size Sub Feed Wires...................Ranges..............-- KW.............. --------- --._..... ........""..
Number of Circuits................... Oven .............. KW--= ....... -'
Number of Meters------------ -----------Signs--------- Transformers........ .......... --------- ------....---
Misc----- ----------_-------- ----------- - _
-------Dryers................--..........---- ...... .......... .......... . ...........
Motors..........;I.--....... HP---� .....----- Phase--------------------
Motors.................... HP------------------- Phase.................... Permit Fee $1.00
Motors....---------------- HP----------.----- Phase.................... HP Charge------- ----1- -:in .��.' n
TOTAL FEES A
�(� NSPECTION APPROVALS .�,I.
Rough Wiring...._.......... ... ------ ------------------ X x
DATE INSPECTOR ATF INSPECTOR
Finish Wiring .."---' ..... ....................
OSTB IXSP[CTOR I IXSPE TOR
Final . --- ------- - '--•"- ------
DST INSPECTOR