436 NO. STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
t
ITYF C-UPERTINO
Date Permit No.
/ •Y•, yiYt� Fee
t Application is.hereby made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed OnhQTrjNnQe side hereof, and agrees to install said
e wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
V1 Use of Premiseq
u
J
.:a Owner i 1,,44
/f Address1431.1- (FLLaV4
M By , '+� �iT . �� Address
COrNTAACTOA, AGENT
,7 G �O/ Approved
Phone: — ELECTRICAL INSPECTOR
NEW RPL FEES
Size Service n uit...z r of
..........Numbe ...1__ -O
Size Service Wires----"f- --------Number of
-------------- ......... .......... ..............
Out""j
Switches
Size Service Switch,&.029RAumber of R�cep ac es............ ir... .......... ....!--------
t
i,4 Size Sub Feed Conduit..................Number of F ies ---------------- ----I---- ---------- ----
SizeSub Feed Wires....................--..........Ranges.............. KW.----------- ---------- ---------- --------------
Number of Circuits._......... .... Oven .............. KW-------------- ---------- --------
-- ----- --------------
Number of Meters........................Signs.......... ransform -------------
._;rs ..... .......... ........
Misc------------------------------------------------I ------- -- ----- ----------
Motors........... ........ HP.................... Phase------------------- Permit Fee $1.00
Motors-------------------- HP.................... Phase--------------------
Motors-------------------- HP-------------------- Phase-------------------- H P Charge---------------- ----------
TOTAL FEES —J rLQ
-
RECORD-OF U5R4C7l0N APP 0 S
Rough Wiring ... .. Fixtures ---------
..
TOR
Finish Wirin ... ...... Motors
1� SP OR
VA E INSPECTOR
Final ..... . ......... .... .....------
DATE INSPECTOR