2016 . NO. BEET LOT NO. / G
'APPLICATION FOR 'ELECTRICAL PERMIT
CITY OF CUPERTINO
Date ��/� ,'195�� Permit No. C:Ae) 116
Fee $ :396a
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 ElectricalQ&e:_.of the
,r City of Cupertino, and all other laws applicable thereto. ^R CT^
^v Use of Premigpq 41
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:7 O er / // Address
Nv0 Y3 �;r'+= Address 3 �o
CO�NjTRRAA/CTOR, AGENT,,,
Phone: Fid Dta 3%^�.c 'µ! ,. '� ApprovedELeerntu1 nasveema
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NEW ,RPL FEES
Size Service Conduit....... .............Number of Outlets...._......._... -- .........
Size Service Wires.....M4..c�, umber, of Switches---------------- ry-- ---------- --
Size Service Switch.._S. .:r57--Nurnber.of Receptacles..._......./23... ..........
Size Sub Feed Conduit------ ---------Number of Fixtures.._.........._.. ---------- ---------- ---
Size Sub Feed Wires........C---
- --------Ranges........ ..... KW.............. .......... .......... ..
Number of Circuits.......... ------- Oven -------------- KW-------------- ---------- ---------- -----------
Number of Meters.........:�5 ......Signs.......... Transformers-------- ---------- ---------- --------------
Misc................ ------Dryers-----:2:.............................. .......... .......... ...
Motors.................... HP-------------------- Phase.................... Permit Fee $1.00
Motors.................... HP.................... Phase............._.....
Motors.................... HP.................... Phase.................... H P Charge._.............
TOTAL-FEES
ilk INSPECTION APPROVALS
IC
Rough Wiring .. .... Fixtures -------------........ -------- ----------------
All INSPECTOR DATE IN ECTOR
Finish Wiring Js.......... .... Motors ------------- _....... ...... ............
-40 --------------------
DATE INSPECTOR DATE IYSt[OTOfl
Final ........ -------
? DATE INSPECTOR
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