2017 NO. STREET LOT NO,
APPLICATION FOR ELECTRICAL PERMIT
/CITY 'OF CUPERTINO y
r Date _ s( �Y , 195/3 . , Permit No.' /
Fee $ z960
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 in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Premi<e<
c
O er Address
' '0 y re Address
CONTRACTOR, AGENT
�CO g6 3` G Approved
lg'
,ne: ELECTRICAL INSPECTOII
NEW RPL .FEES
Size Service Conduit...4'�.....m............Number of 'Outlets........._....... SS. ._........
�....:.:..r...
Size Service Wices...:j .✓!.". .Number of.Switches................ :-
Size Service Switch_$.-.:..--.-Number of Receptacles------------ ._)3.. -------
-. .,. :........
f ei
Size Sub Feed Conduit..._I/...........Number of Fixtures------------------ ---
--------
Size Sub Feed Wires....... .......... anges...----- KW.----------- --------- ------- --------------
Number of Circuits...---.... _ Oven -------------- KW......... .......... ..... .. ..............
Number of Meters........................Signs.......... Transformers........ ...,.,.. ---.----.. .............. -
�J
Mise---'---'-.......�...-' i'..`..c.l�---Dryers.._.2-------------------------- ------- -------- -------------
Motors.................... HP------------------- Phase---
Motors-------------------- HP.................... Phase---------- -----.-- Permit Fee $1.00— .
Motors-.........-------.. HP------- ---------- Phase.............._--- H PCharge------------- _ .C...
TOTAL FEES jZ ~ '
CO F INSPECTION APP$OVAL9,
Rough Wiring�z.l- ..................... Fixtures .. _.----I---- IQ
- -- ._.......
,/ DATE SPECTOR
Finish Wiring f b'L Motors .. A
............ ... ... .. . ............. -----'XL.L DFinal ---I--c .-I. �FCTOx
DATL IX9C/•Y[CpT_+TOR--
TEMPORARY ELECTRICAL SERVICE
DATE: ....../.� /-/.. 10� �To
Fee: ............. . ......
OWNER: ---
AT: _9VI-76
LOT: ---
/............................................................N------------------------------
REASO: - ----- - �h.e for-the-elect-r-ical service at the above-1oca I tion,
N:
d a Ire I it
The d 1�,, responsible
u �0""""
nti e- bi it 'ng s ready for occupancy, and is released by the Building Department,
C of C
Kn11, ..... .....
.......... ------- ................. -------------
I,
INS OR
116 1/63-500 ;,�rENANT _-"r
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUIIDINCnINSPECTOR'S OFFICE
C�_*k CITY OF -CUPERTINO
-------------
..................
TO
Yo are hertby aifflioriz connect electrical service'
Owner or Tenant .........
At ............
............ .... .... ...... ... ............. . ....... ----------------------
No. of Wires -------------- ......iSize of Wires ---N
Size of Switch
Motor Load -------------------------- Voltage ------------ ----------\j
Heating Load ------------------------ K. W- ----- .. . .........._ Voltage ....... ........... ......
No. of Metem. ItO------- N S
Lig' New ery ce---.. ...... Reconnect............__..
Heat :,*,,�..... 220. T/1m, Ire.----_--------- Move Service.--.._....
No. of Add. Meters....-.-.....
Power............... Three P e._._....._... Move Meter........--....
. . .... . ...... ... ... ........ .. . . ---------
104 1/63-500 ELECTRICAL SP TO
"TEMPORARY EVIC;TR1 A.1 RVICE
1I ,
Fee:
rte/ v _
�,,.�, - .......................
OWNER: .---""f----�.ut..-�"
.
LOT: _ �.................._......_C._. -----....-...._...._. ..-V�GZ'tir�'�
`�--
REASON: ........ .... . ............... ........_-.._..._.._................_..........................
The undersignedAufl
agrees to be responsible for the electrical service at the above location,
s ready for occupancy, and is released by the Building Department,
��ppFh6n� ®..t f.......... .. _....... .... ...... . - .........PE ' R ' . ..NT (R OWNER
ar
TEMPORARY GA_;S� �SERVICE
DATE: --------------- /....�3
/ �r T, .
..--� . .. ......Fee: ...............................
OWNER: ......L... � 9 !C� :: :_r..-c � !n4W...
AT:
LOT: -` --------
� � (REASON: ...-- 0. 4G7 // r .............
.D.. .._ ------..
The un ersig d agrees to be responsible for the gas service at the above location,
until We bui i is ready for occupancy, and is released by the Building Department,
City f Cup rti o.
Phj• �^� `bl �- /
- ----------- .. .......
.. ............
INSPECTOR TENANT-
117
ENANT O &R �c
YI 117 1/63-500 >s>.�.��,�� � �R