2511 2veff/ 7,-Lw—
NO. _
'I'REETLOT NO.
r gIFIDEC
APRS LA I�O `OR ELECTRICAL PERMIT
4
3 < }.OF CUPERTINO
W 9 .11963o
�/
LL' Date �Y �/ 19�,,�� Permit No. "�:�
CITY Ut UuFtKIINU Fee
zm Application is hereby made to the City of Cupertino for a permit to install electrical,
a w +^rr,
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said"e''
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
'> City of Cupertino, and all other lairs applicable thereto.
03
oa
z J Use of Premises_
J
J e
3 a` Owner Address
a By _ Address
770 Sout aU dM-�Niox 921
Ta o.. Approved
_ o.. Mountain View, Calif. ELECTRICAL INSPEC101
i +
tt�y�(
'4 State License: /7D 57J'� __ '
NEW RPL FEES
Size Service Conduit_....................Number of Outlets....... --- ----------
Size Service Wires..........................Number of Switches -_---- ... . .. ........ 6/r d,-C
Size Service Switcgki!�.............:------Number of Receprack . .. .. ......
Size Sub Feed Conduit------------------Number of Fixtures...............
.... .......... --------- --------------
Size Sub Feed Wires-------------------Ranges........------ KW------------ --- --- ---------- --------- ---
Number of Circuits._................ Oven .............. KW----.....----- --------- ---------- - -----------
Number of Meters........................Signs..------.. Transformers..,..... ....------ ---------- -------------
Misc------------------------------------------------Dryers----------------------------------------- -------- - ---------- ---------------
Motors..----------------- HP--..........--..._. Phase-------..:.:.....--
Motors.................... HP-----------------... Phase.:...... ----------- Perrnit Fee $1.00
Motors-------------------- HP-------------------- Phase I...i................ H P Charge....------.....
--- ------ -
-
•
TOTAL FEES
R
�CgRD OF INSPECTION APPROVALS
Rough Wirin/ ----------- Fixtures ......................I ---- --- ------ -----
T-
M, ......... .... ... ..........
DATE INSPECTOR DRE INSPECTOR
Finish Wirin77
......!!-------- . ..............�( tor, .... . .....
SIR 4p OR DATE INSPECTOR
p Ti-C.1 INSPECTOR
t4e ....... ..........
'-�A -�INS;ECTOR
DATE
T-