1135 �.
NO. TRe LOT NO.
pSr
N R ELECTRICAL PERMIT
EP 13 1961 CF CUPERTINO
DateCITY OF' CUPERM195— Permit No.
Fee S /
Application is hereby made to the City of Cupertino for a permit to install electrical
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 Premig,g
' :a Owner
kfic"!:li•l �eIli?�S 81� LG&l fl `n�� r4 1.16Z �7icu�• 4I ✓. ria c w
Address l
h / X: CONTAACTO/JR, A'G'E[NT/ Approved
ELECTRICAL INSPECTOR
NEW EEL FEES
Size Service Conduit------------ .........Number of outlets._:.............. ........'. ....__-- ------ -------
Size.Service Wires---_--------------------Number of Switches................ :--....._. ........_ ............
Size Service Switch........................Number of Receptacles.. ......... ......... ... ...... .....--------
Size Sub Fred Conduit..................Number of Fixtures..-............... .......... .......... ............
Size Sub Feed Wires..............._..Ranges...-'--........................ KW-------------- ---------- ---------- -----_-------
Number of Circuits-.................. Oven --- ---...... KW-------------- ---------- ---------- ---------
Number of Meters------------------------Signs.......... Transformers........ ._...... -:------- ------------ -
Misc................................................Dryers------------------------------------------ ----.----I-------- -------------
Motors......:------------- HP................ ... Phase--------------------
Motors.................... HP-------------------- Pha'se..........:_r,------ Permit Fee $1.00
Motors.................... HP-------------------- Phase--------- ........ H P Charge---------------- -------------
TOTAL
RECORD OF INSPECTION APPArA
Rough Wiring................ ---------------------------- Fixtures eY
DATE INSPECTOR
..
Finish Wiring ................ ----------------------ESTE INSPECTOR Motors
C-9 . ...
• !.T
DATE XSP