1867 i
NO. ST E ' LOT NO.
,/k P `TIN' FOR ELECTRICAL PERMIT
��
GI 10F CUPERTINO
JAN V 4953 L /
Date — 195— Permit No. `
((�+'I Y�/ (� �F{� J Fee $ I o
AppliLl[Yis h'e�eby AP P6th8�Cify of Cupertino for a permit to instahectrical
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)applicarble thereto.
v Use emisr< '^-
c
V
a Owne Address
v
Address
O*N�ACTOR, �1ONTRACTOR, AG
�`' I Approved
gn 4N.
Phone:�-- / - ECIRICAL INSPECIVI
NEW RPL FEES
Size Service Conduit----------------------Numbcr of Outlets------------------ --------- . -------- ---
_........
Size Service Wires................ .......Number of Switches--------- ------ ---------- .
Size Service Switch........................Number of Receptacles............ ---------- ---------- --------------
71O
Size Sub Feed Conduit-......_.-.......Number of Fixtures------------------ .......... .......... ..i.�. .->.
Size Sub Feed Wires....................Ranges................ KW....--------- --------- --------- --------------
Numberof Circuits..----.--------- Oven .............. KW.... . ..... .......... ......... ..............
Number of Meters........................Signs.......... Transformers--------I------- --------- --------------
Misc------------------------------------------------Dryers---------------------------------------- -------- --------- --------------
Motors.................... HP.................... Phase.--..------------ Permit Fee $1.00
Motors------------------ HP.................... Phase.----------------
Motors------------------- HP.................... Phase-------------------- H P Charge.------------- --------------
� o
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring-----.....---. --------------------------- Fixtures -------------------- - -----------...----------
DATE INSPECTOR DATE INSPECTOR
Finish Wiring ------......... . ... Motors ..... . ................-...-...
DATR IXSP[CTOR Final �. .. T._?.�.. - I.. . ..INSPECOa-------
DA [ INIP[CTOR