NO PERMIT NUMBER,.
I�3 �D
4 � NO. LOT NO.
APPLIC '. i �. FOR ELECTRICAL PERMIT"' .
CITY OF CUPERTINO .'
Da ...pb 19% O.. Permit No."
Fee $ ..
Application is hereby made to the City of Cupertino for a permit to install electrical
�• wiring and/ISr4ixtures as listcd%n 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.
Use of Premie—
r
Owner,�r /l :' ` ✓' Address = + �\
Address .• r
CONTRACTOR, AGENT Approv �' • ki ;
. �
I NE EES
AL-0
V �mber -ow",
Size Service Conduit------*1 of *6utlets-I----- .... 17
-----------
e-8er"ViAz Wires.....�:.APJV.�r...Mrnber of Switches------- - ---------- -----------
s
Size % -
i:� . :1
Size Service Switch.........i-01r.Number of Receptacles..._ .Ir, j�.,
..... - ---------- _air--------- -
Size Sub Feed Conduit------------------Number of Fixtures-------- ......... ... . .......... .
Zi
Size Sub Feed Wires..._.............Ranges........ ...... .KW......... ..........
Number of Circuits.__.......-- .. ,01ven KW .. ......
...
an
Dry' .......
-i--� ers: ................................... ..
Tr $formers, . .....
;vimv--------
Moto!=4-
s...................c HP------------------- PIMP------------------ Pen�ajt Fee. $1.00
��I
� .......... --------- Phase.
pp;- , --------------
M 0i4p.....n�I ----I.............. 71
tors;..........r.., f--- ----- Phase H P Charge-------------- .........
K. Ij. .1 11, -1 �
TOTAL FEES ..4
F INSPECTION
Rough Wiring/?�J/twjow%........... Fixtures ......
M",K OR
!16, ......... oto
Finish Wiring ......w rs
Final ...IXSR[CTOR DATE . .
....
SERVICE CE OFFICE
ELECTRIC,. , lj�
�4- * BUILDING"04SkEcr6li,s, ' 'I
1 0 V
CITY OF CUPERTIN;
......................... ...A........I.............................. 196./.
To
You are her'e'by autho
'�t�oonnect the.E+ CTRIC servicefr
Tenant ---
Owner or Ten 5
...........
At .
...........
--:r Phase-----------------.......A.
jag ............ K. W. -----
----------- ........... Voltage ...............
............
Light ..............t 10 ...,,..::..::.:..New New Service..................Recohnect ...
No. of Meters ......... Heat ..............Yin *�.........
No. of Add. Meters .......... ......Three Wire ------------......Move
(Power ...........r.:^: ; ' - ..'
eep . ......:..........Move Meter ............
........................................
bd i/co-500 ,�ELECTRICAL INSPECTOR777�