1582 00301 -
NO. _ 5TREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
6e� tl1®" TY OF CUPERTINO
Da � , 195— Permit No.
l Z
J 5'D
Fcc $ ._
A lication is he��reJ�b [m�]a,de1 tno'(Ch�e City of Cupertino for a permit to install electrical
wer ff yndN fi�ji'tY'F'ERTPen 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, a1 other laws ap blle thereto.
A; Use of Premi
c
'a Owner Address
By {, . Address 2
CONTRACTOR AGEVr
'Mi Approved
Phone X , — ' ELECTEIKAL INSPECTOR
NEW. RPL FEES
Size Service'Conduit--------------:..-.Number of Outlets:...:...:....:.... ---------- ---------- ...........
Size Service Wires.........................Number of Switches................. ..... .. ........- ..............
Size Service Switch..............._.......Number of Recieptacle�
S------------ ---------- ---------- --- - --------
Size Sub Feed Conduit------------------Number of Fixtures......-_....._.. .......... ........ - --------------
Size Sub Feed Wires...................Ranges......--....................... KW............. .......... .......... ..............
Number of Circuits------------------------- Oven -------------- KW-------------- ---------- ---------- --------------
Numb
..........Signs---------- Transformers--'--..- ---------- ---------- --
Misc. Q,I-E---Dryers--------------i------------------------- ---------- ----------
--
Sa
Motors----------------- HP.................... Phase....................
Motors-------------------- HP-------------------- Phase ------------------- Permit Fee $1.00
Motors-------------------- HIS------------------- Phase-------------------- H P Charge----------------I......I
TOTAL FEES------J
RECORD OF INSPECTION APPROVALS
Rough Wiring................ ............................ Fixtures ---------------------- -- -- ----
DATE INSPECTOR DATE I.
Finish Wiring----------------- ------------------------- 4..........
DAVE INSPECTOR
!LFnaol D TZ ......
ELECTRIC* SERVICE-NOTICE OFFICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
To
You are hereby nthor]zed to connect flip ELECTRIC service for
Owner or Tenant V " "•� 1- -.�„�:L-!..'Z. c Tt�
.. .
At_.. .c
�....... Size of �. ..................
Size of Switch
No. of Wires ......--- Z
Motor Load --------------------- Voltage ................................ Phase_.....................
Heating Load ......... ...... K. W. .................................. Voltage .. ....... ........ .----------
Light .._...
....�. � ........._-...New Service .................Reconnect ................
No. of Meters ....... ....._....�( Heat ......�I22(i .........__._ hrre W' e ...Move Service ....:.....
No. of Add. Meters ..._..... power hree has ......
_....._...... rr....-._.Dtove Meter ....._......
i V
.
ELECTRIC INSP R
104 7/61-500 -