870 No. STREET �,' LOT NO.
APPLICATION FOR ELECTRICAL` PERMIT- -
l� F CUPERTINO
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. - , 19G Permit No.
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V, pplication is hereby'I�made'ebT11NQty of Cupertino4for a permit to install electrical
V 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
v• City of Cupertino, and all other laws applicable thereto.
1 v Use of premises 1-1,4Y6 I,
t Z a Owner' -� tldress
�By -d J %' 7 Address % L
NTAACTOR, AGENT
(,/C� Approv
�/ N ��• �v ELECTEt L INSPE
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ELECTRIC SERVICE NOTICEerYrt
BUILDING INSPECTOR'S OFFICE }
CITY OF CUPERTINO : y "
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To; •
ra , ' .. ....... ........ 196D.
You are hereby aut ed �connect the RIC service ifor-
Owner or Tenant .- ./--
G �
- ......
No. of Wires ...11.,q...........,. Size of Wires .--.. Size of Switch
MotorLoad ............................ Voltage ................................ Phase....--_............_..._........ . .
Heating Load ...........- ......... K. W. ------------------------------- Voltage .. ---
I . v r
Light ..............110 ---.............New Service...........:---..Reconnect ....----........ ,
No. of Meters -- --------------- ,.
Heat --------------220...'r--..:...Three Wire ...............Move Service ........-.
No. of Add. Meters .---:.-...
Power .............. e P . ...........:-'.-Move Meter ----------- .:
loo 1/6o-5oo ''" ECTRICAL INSPECTOR