1422 NO. ✓Tf,l TR �T LOT NO. -
® CI1- •t �QR ELECTRICAL PERMIT
AY 181962 c iOF CUPERTINO
., 1
-Date19�Z' Permit No. I ,Z
U� PERTINO Fee 's
(� Application is hereby made to the City of Cupertino fora permit to install electrical
Ib 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 t:
4) City of Cupertino, and all other laws applicable thereto, t' 1
v Use of
C ..p
a Owner:
kmr,, RPL PEES
.._...:::.........Number' of Outlets..........._.....
Size Service Conduit. �i.. . .... ......Size Service Wires .....
-------- -- -Number of Switches....:;...'y . '.. . . .......... _—
Size Service Switch..
------------------Number of-Receptacles._..... ........ ------ -------------
Size Sub Feed Conduiti---------------:-Number of. Fiztures_.::':: i:.'::. :..:...... .......... .....
"
Size Sub Feed Wires...................Ranw ::-.,.y
ges ------------- ----------_--- -`----- ---------- - -
Number of Circuits------------------- - Oven. ' 1
. ,�.
.. 1,
......... KW------------ -------- --------- ---
Number of Meters.................. .Signs-..--:.:.. Transformers._.---- ---------- --:......
Misc. ----- - .... '-^.:..... Permit.Fee .
Motors-----t-`v-.. HP - A Phase-----:..._......... ` $1;00^
Motors.........---=---- HP------------------ Phase....................
' Motors...._.....-. .-'.'.' Phase. _ j�
-----. HP...-------�- - .-...-_ '.._--.. H P Charge".."-.....-...:::L.,..--
�TOTALFEES � t
RECORD OF INSPECTION' APPROVALS °
RoughWiring................I.......................=-- Fixtures•.---------- ---------------_.-
OAT[ INSPECTOR OATS INSPECTOR
Finish Wiring--wo;�^•��j:�e I' Motors ..
S
DA TZ �'�{ INSPECTOR DATE INSPECTOR n'
Final ,.
.-..— -DATE - INSPECTOR ^r