1875 tt �S(o � e o ,Jd
LOT NO.
APP
LIC T �.� FOR ELECTRICAL PERMIT
JAN 21 106 '4c-,iCITY OF CUPERTINO f
`Ca 0r f . �� � �i�tf• 195— Permit No.
Fce $ Zoo
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 n ordance with the provisions of the Electrical Code of the
City of Cupertin and all ier laws /apClicabl theretm.o..
J Use of emi � -"�`t \ �--XS•� .
V
Owner C \
a s
v
14 By Address
ONTRACTOR, AGENT
Approve
Phone: LE CAL IN P8
NEW RPL FEES
Size Service Conduit.....................Number of Outlets....... _..._-------
Size Service Wires-------------_---------.Number of Switches---------------- --------- -------- .__._...---
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-------------------- Permit Fee $1.00
Motors.................... HP------------------- Phase-----------........
Motors----------------- BY------------------- Phase.................... H P Charge..------- _-
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring----------------j-------------------------- Fixtures ----------...-------- -------------------------
DATE INSPECTOR DATE IRfSECTUR
Finish Wiring ---------------- Motors - -------......
PATE
DATE usPEvoR E E
Final/= ---------3 I -----
FATE IIISPECTOO
OFF COP
LECTRIC SERVICE\,NOTICE
BUILDING INSPEcTOR'S��,OIJFICE
CITY or CUPER'riNO i
.......... ....../777.�
jTo ............... 196.2S
You are hereby aut19d to connect electric v¢ r
, dr
Owner or Tenant ... .... ........................
At
............................----------------------
No. of Wires ............. Size of Wires ZZ '�
------ Size of Switch ✓ ....14.
Motor Load .......................... Voltage ----- --- -------------- ----- Phase ..................................
HeatingLoad ........................ fc<W- ---------------------------------- Voltage ................................
No. of Meters.... Lighr`--�:::� _,—N— Service.__...........
er�ice------......... Reconnect..................
....... Heat. 220...-------- Three Wire................ Move Service............
No. of Add. Meters............
Power.............. v" Meter..............
104 1/63-500
v I MCIL "s"clo,