2471v
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< NO.- STREET LOS NO.
�y
A® OR ELECTRICAL PERMIT
Y(n.
¢I OF CUPERTINO
25 19 3 W
//
Date l� � Y 195L3 Permit No. c:V%/
CITY OF CUPERT�'C 1=ee
a.00
Application is hereby made to the City of Cupertino for a permit to install electrical
wiring and r 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
Owner
By (A/(J/
CC CONTRACTOR, AGENT
Phone:
Address
Address 3?
Approved C� �-
ELECTRICAL INSPECTOI
NEW
RPL FEES
Size Service Conduit ......................Number
of
Outlets...........................
..........
... .
.-.-.-
Size Service Wires.............._.........
N
................... -------------
-------p-G-- ati,
'
Size Service Switch ........................Number
of
Receptacles...............
..
/.....
Size Sub Feed Conduit..................Number
of
Fixtures ......... ......... ...
----------
!�..�
Size Sub Feed Wires ....................
Ranges ----------------
KW.............. ----------
---------
--------.---
Number of Circuits-------------------
Oven --------------
KW-------------
Number of Meters.......................Signs..........
Transformers--.---- ----------
..........
......--------
Misc----------------------------------------.
Dryers ...
-------------------- ---------
---------
------------
Motors -------------------- HP--------------------
Phase --------------------
Permit Fee
$1.00
Motors-------------------- HP--------------------
Phase ---------.....---
�---
�
Motors .................... HP--------------------
Phase
.------- H P Charge------
----- ....
p
4 7!e
d-----------
s
-TOTAL FEE
INSPECTION
/O F INSPECTION APPROVALS
_
Rough Wirinl�`---` — `---......_-. Fixtures ......
OATE
FinishWiring._.............I-----------------------
DATE
INSPECTOR
INSPECTOR
OI.T[
Motors ......---- .........�---
^TC_rC
Final ......�.j L-- ---------
INSPECTOR
........--------------
TO
IN PECR
----------
INSPECTOR