2108 NO'.,-4
STREET, r r L. -�: LOT NO.
i I.rn�j l F
• '-i �; ;:�• -AF!PLICATION FOR ELECTRICAL PERMIT. ,
CITY OF CUPERTINO '
ci
Date -� - 1 5_ Permit No.
1/�.#Y' VL' UVI Lit A . 1.
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
n4 wiring and/or fixtures in accoidance-with the provisions of.the,Electrical-Code of the. ;
y City of Cupertino, and all.other laws applicable thereto.
Use of Premise .21
a
Owner � �—��� 4 ZAddress
ro By/// r���.i-/i4•%i-(��v Address
N CONTRACTOR; AGENT
11A .Approved
Phone: �� �J(/ \ E E ZGL [NSFBCrm
NEW RPL, • FEES V.
SizeSe'rvice Conduit---A�/,e:..-.'._`•Number of On e s ------- ----- -------
'Size Service W -- ---- ......Number wi s---------------- ---------- ---------- --------------
ire$_:Jof SwitchestchN ,
� r *3
Size •Service Switch...ZM�----Number of Receptacles.'..'..'..'--"- 3_ .............
Size Sub Feed Conduit. Number of Fixtures----- ----;,..._. .A A--- -----------
Size Sub Feed Wires-------------------Ranges.......
......... KW. ............ ........... ---------- ---------
Number of Circuits................... Oven ......III........ kW...:............ ....1------ ---------- ------
Number of Meters_-_----------_-------Signs.......... Transformers........ ------ .......
Misc.-------------------------------- Dryers .... .... ------7�
- -- ---- ------- - -------------*------ -----
Motors...... me--------
Motors Motors...._........................ HP.- ji�Ph ----- Permit Fee $1.00
............. HP--- ---------------- Phase............._...-.
Motors-------------------- HP-------------------- Phase--------------------- H P Charge-
----- - -
--- -
TOTAL_
RECORD OF INSPECTION AP
Rough Wiring Fixtures
L TOR
N SPEC
Finish Wiring LL� 2�__ Motors ---------Q,...
1-1INSPECTOR
----------
0 T INSPECTOR
�I DLT[
Final ---
IN SP KC T 0 R
OFFICE COPY
ELECTRIC SERVIC; OTICE
BUILDING INSPECTOR'S OFFICE
CITY, OF; CUPERTINO
. . ' ........................... "
I
To '
You are hereby author' ed;to conged electrical service . .
' Owner or Tenant .:.:............. *'�p/1�
At ....:.........
�.
y .... ... .. .. . ..... ...`-- -t........
No. of Wires --------- :........ Size of Wires :......... Size of Switcl+'.()o�Ay���J'�
Motor Load .......................... Voltage ................................. Phase .............-:............t \ .
Heating Load ........................ K. W. -------------------------- -------I Voltage ............ ................
Light__✓..... 1t0._ New Service.
No. of Meters......._ :...._.. ... _,,—- Reconnect.__.............
No. of Add. Meters............
Heat........ 0.....y,..r'1'hr ,Wire41NSPECTq"�.
ove Service...........:
Power............... Th Phaseove Meter..............
104 1/63.500 £LECCRIC