2203 a �s o ���-� ��-�, �.
NO. STAEGT LOT NO. . �
�APPLI��ION��F,OR ELECTRICAL PEitMIT
�C TY�OF CUPERTI[VO
' J'�� � 6 ���� �.�; / �d�
Datc , 1955¢_.3 Pecmit No.
CITY �?6� ('UP���`""' �« � ,S� o d
Application is hereby m 8 u'�the_City of Cupertino for a pe[mit to install eledrical
wiring and/or fixtures ns listed on U�e reverse side hereof, and agrees to install said
wiring and/oc fixtures in accordance with the provisions of the Eledrical Code of the
City of Cupertino, and all other laa-s applicable thereto.
a Use of Premices i 1\0 .c� oall B•Q �.c..�.pQ��
v �� � � '-(
'a Owner Address -.. ��� �4..�u�.,
h AY Add 6�� �
N CONTAACTOA� AGENT
3 S b-u y a� Approved d�E
�ione: ELGCTR(GL INSPHC7bi
0
- - � � �NEN RPL FE[5
Size Service Co duit.._----------------_Number of t :_....:I....._.--.--.
SizeService ��----....._------n�---N r of S � s... .. . .. ...... .......--II--.._-----�
Size Servic � ch ...... . .. ... . � o R , ptades..........� �.... ------ ------._....
'�$' � e n �t..................Number of F' � res--- - .... .....---- --------- ..............
eed �res-----� -- . ... .. ........... KW..........-�-- -------- ----�--... ._..------
Nutnber/��ytd�ts`... ............ Oven -----�KW--------.... ._..--- ---.._--- -----.._--...
� � y �i
Numbec oF Metecs............ ... ... .Si .. . sformers_...... ...------ --....--- -----._......
Misc.---...----.............`----- ^-- -...- --Dryers.----.......------.._--�--------... ....----�..------ --l'•"_'_�
Motors.................... H .---...-------..... Phue------.---------�� Permit Fee $1.00
Motocs---..--__--....... H .------_..------ Phase--�-----_....----
Motors...............-... HP...-----"------. Phase....-�------'--..... H P Cliarge..--..._--- ---�'--'-
TOTAL FELS �a
RECORD OF INSPECTION APPROVALS
I Rou h Wicin ... Fixtures ...-.------"------ ----'-�----
.._.
8 ...---......
.....---"-�---'-"-----
-'
DATC �MS�ECTOfl TE ECTOR
Finish Wiring �_ Motocs ... . .... .. �
..._. . ....------
..-_- '- ---
----"-'........ ........"--- ...
o�re IXS�FCiOR -. /f�r � a
71 _.... 'G.._' ".....I.... "_"' '__.....""..
o�r �xsv[cros
!�