1075 N STREE - LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
` OF CUPERTINO
DateC i A51J 19bjj !!�, Permit No.
Feed d5
AOIN or the�9lpy� l(�gCity of Cupertino for a permit t6 install electrical
wiri jn ud s 1 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 Premises1J
c p
a Owner Address 2-07,?-'7 j 1il[doc
1'^ By Address ems/
CONTRACTOR, AGENT
`., Approved
CTRIGL INSPECTO;
NEW RPL FEES
Size Service Conduit----------------------Number'of Ouilets....... .......... ......!... I �D
Size Service Wires.......-...._....._.--.Number of Switches.._............ .......... .
-----------
Size Service Switch........................Number of Receptacles------------ ---------- ---------- --------------
Size Sub Feed Conduit.............._..Number of Fixtures-----:------------ ---------- ---------- ----------
i
Size Sub Feed Wires...................Ranges------7"----- KW-------....... .......... . ....... .,..(J.. ...
Number of Circuits................... Oven .............. KW ....... ..... .. ...... ..............
Number of Meters........................Signs---------- Transformers-------- --------- ---------- --------------
Misc---------------------------------------------- -Dryers.-------------------------------------- ------- --------- -----------
Motors------------------- HP------------------- Phase....................
Motors.................... HP-------------------- Phase-------------------- Permit Fee $1.00
Motors-------------------- HP-------------------- Phase-------------------- H P Charge--------------- ------�-9---/
TOTAL FEES /I n j
RECORD OF INSPECTION APPROVALS
Rough Wiring................ -- Fixtures ....-------------- ---------------------------
GATE INSPECTOR .ATE INSP CTOR
Finish Wiring . Motors .....!...... }
.ATE INSPECTOR y' O E .. , `
Final ����-/--....� .....
GATE IXSPECTOE