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1009 �n NO.. I �0 ZZ' STREET =5a---�iJ LOT NO. ELECTRICAL PERMIT I CUPERTINO MAR 2 8 1961 Date_ ' 195— Permit No. Z10 0 ATX Q� y'�PePIe � ere s /, Appl i is reb e t e � y 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 GG4il9 c a Owne Address '✓ rF y BY. _ _ Address "CONTRACTOR, A £NT _v fes -Approve done•' S7 a&k CAL rN5►ECTO[ NEW RPL FEES Size Service Conduit----------------------Number of Outlets................... .......... ..........I.............. Size Service Wires--------------------------Number of Switches-.-------------- -.-I---- ---------- 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........ .......... .......... ............... Misc--------------------------------- ---Dryers._------------------------------- --------- -------- -------------. Motors--- ---/......... HP ��----- -- Phase...._..--------- Motors.................... HP.---------------:- Phase.........---------- Permit Fee $1.00 Motors.................... HP---------------- Phase-------------------- H P Charge------------ /-1-7 TOTALFEES RECORD OF INSPECTION APPROVALS RoughWiring-..--................ ---------------------------- Fixtures ....:................. --------i------------------- .Are INSPECTOR DATE INSPECTOR Finish Wiring ..----'-....... --------------------- t otors -------- ...... �------ --- DATE INSPECTOR �j AT oa , nal ,l/.l.�f DATE INSPECTOR-'••.-