2249 1.
No. STREET ' LOT NO- ------------lJ.....J.....-----------
APPLICATION FOR ELECTRICAL PERMIT
�
C[TYI. OF cUpegtf
Date.......... ....._!. �/ (�
�i ----------- 196-o Permit No. ----------- . ----
-
O i Application is hereby wade to the City of Santa Clara 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
c City of Santa Clara, and all other la% applicable thereto.
v
m Use of Premises
Owner .. . .. .... , . . ..�(/f Q Address --- .
Seo---rA �.
By ...- � � Address �! f
/�'1�/'�y.. - -- - --
CONTRA TOA, AGENT �
4' Phone: Ahhr �_.
.-� z p ELE L INSPEC701
NEW EEL FEES
Size Service Conduit.....................Number of Outlets. ...._------.-- -/�-- ---------- -
Size Service Wires..........................Number of Switches................ -
- ---------
..
Size Service Switch........................Number of Receptacles.......----
. .... .. ......?
Size Sub Feed Conduit------------------Number of Fixtures------------------ -/..Ae--- --------- --------------
Size Sub Feed Wires.----._------...Ranges..------1.... KW_............ ---�/
-- --------- ---------
Number of Circuits------------------- Oven -----./-"------- KW-------------- --/- - - ----- --------11:5�
Number of Meters..............._.......Signs.......... Transformers........ ..----/--- - ------------
MISC----------- rte, ------------ ---------------Dryers.........../------------------------- -----7::-�r
Motors------ HP-------------------- Phase- - Permit Fee $1.00
Motors.................... HP-------------------- Phase-----------------
1%
Motors.................... HP-------------------- Phase-------------------- H P Charge-----....------- i7 I
TOTAL FEES 6;7-go
Rough Wiring I/...o- EC OF INSPECTION APPR))VALS
...... Fixtures .. ......
---7-------*1 ------ ------ ------
INSPECTOR tors ----------5���CTOR
--------- - .. -------
DATE INSPECTOR E-
Finish Wiring ............ -------------*--------- It
'inal
DATE k INSPECTOR