2160 Jo 3�y. P � se .Y . s
STREET LOT NO. '
rp
AP,PLICATIO FOR ELECTRICAL PERMIT
JUL 8 CUPERTINO
Date A y— e- - 7--. -----moi rc � Permit No.
Cf) lil I Y U hUVLKI1H11f F Fee $ /y 6s
Application is hereby made to the City of Cupertino for 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
City of Cupertino, and all other laws applicable thereto.
v Use of Premises P 2S�c�-Q,.� O �.
c ,
'4� Owner CrZ�� Evv�.n' WQ. Address q6a co . c��Qe.,C
ro By _Him G\c, L Address o K )PSISu.
CONTRACTOR, AGENT L`A A [OVed '
(�, Phone: hl E 6_ 0 7 UO PP. E} ctnteaL INSPECTOR
NF�W RPI_. FEES
Size Service Conduit..............----...Number; f butiets-;................ ...- /
-- - ------.... .. ---
---
f
110
l
Size Service Wires;.._ No
4switcliesl------------ . .......... .....
Size Service Switch------- - of Receptacles.. ....-... .-- -�.P . ........ .3.:....0.
Size Sub Feed Conduit..................Number of.'Fixtures.----------------- -4Z/.. ..._..... ..
Size Sub Feed Wires-----------I---------Ranges...........L KW.........,.... ....-.1. .--- ---- -----
Nwnber of Circuits................... Oven ...... ............ ......./ ---------- . ..........
Number of Meteis........................Signs.......... Transformers --------- ------
Misc........ -L---------------- ---- ---------Drers�- -----..- - -- 75-
--
Motors.......e7i...... HP... ---------- PheY Permit Fee $1.00
Motors.................... HP...i---------------- Phase--------------------
Motors ......... HP...... ............. Phase....-............... H P Charge--------
TO"TAL
Co OF INSPECTION APPROVAL
APPRO AL
Rough WiringFixtures
. ..... .... ..... .
......
DA INSPECTOR E 0.
Finish Wiring --------....... ---- Motors --- -------- ,-----------
O.I TE INSPECTOR ..T. PECTOR
Final ........... ...... .A---
.... - -- -------- .......
DATE INSPECTOR