2228HIT LOT NO.
V
AAIPPLLICO PR ELECTRICAL PERMIT
JuL' 22 7963 , �I.T'1r.'OF CUPERTINO
Datenr*v 'Ir M IDCpT-it\If1 195— Permit No.•�'r�
v I E.T.
Fee S S, cc)
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 Premi " Y- 7 G bell
c •
Owner Ad es��n �� �C� /U It A. SN
i B Address
CONTRACTOR, GENT
C) • .'e:d Approved
MC;;aLVAL INSPECrO$
I.
NtiW RPL FRES
Size Service Conduit .......L._..........Number of Outlets------------------ --------_ ........................
Size Service Wires ..:..........:...........Number of Sd•it6es.......... ........_ ..........
------ ----
Size Service Switch ........................Number of Receptacles
Size Sub Feed Conduit..................Number of Fixtures....
Size Sub Feed Wires........:..._.....Ranges................ KW
Number of Circuits ................... Oven .............. KW
Number of Meters........................Signs.......... Transformers
Misr-------------`------------------------------ Dryers----"--------------------------- I ---------- I ---------- ..............
Motors .................... HP .................... Phase ....... ,............ Permit Fee $1.00
Motors .................... HP .............. Phase ...................
Motors ------------------ HP ------------------. Phase -------------------- i4 P Charge -------------- ------.-------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring/6 .--- ................. .. Fixtures ..................... -------
DATE INSPECTORDATE NSPECTOR
Finish Wiring ---------------- - Motors �... �.........
_DATE INSPECTOR �+T // INSPECTOR
Final _::1-1..193.. .......
A �� 1 `� DA E INSPECTOR