2015 LOT
STREET LOT NO. .
��APPLICATION,�FOR ELECTRICAL PERMIT
CITY .OF CUPERTINO
TAY 14 1,963 _
Dat//e�. _ pp�� fly 195('3 Permit No.
UIfY 041:
1•iir�tief ' Fee
Application is herebymadeto 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 Electrical Code of the
City of Cupertino, and all other laws
applicable thereto.
v Use of Premises Z/61"l, f"G�
c
a O ner Address
y r"` Address
CONTRACTOR, AGENT
FX `/�� U Approved
0 ELECIRIUL INSPEC701
' NEN RPL FRES
!Z A �
Size Service Conduit.........._.............../Number Pf Out:=ts...._............ .s--- ---....._ --------- �
Size Service Wires------ of Switches................ 5 .. _........ .. .r..�V
Size Service Switch..�-f.d7----Numbeu of Receptacles------------ .. ..........II.f�..3.�
Size Sub Feed Conduit------------------Number of Fixtures.................. ....`.'. . `�
Size Sub Feed Wires......4..........Ranges........ ------ KW...---------- --------- ---------- ---
Number of Circuits---------6---- Oven -------------- KW-------------- -------- --------- --------------
Number
------------Number of Meters........................Signs.......... Transformers-------- ---------- ---------- --------------
Misc.----Crf--�:-:5. ...........Dryers------------/L............._...._..... ....------ - ...... ------.SO
Motors----------- -------- HP.................... Phase-------------------- Permit Fee $1.00
Motors------.----------- HP---- Phase--------------------
Motors-------------------- HP--------------------- Phase-------------------- H P Charge----------------I--�`-n
TOTAL FEES
O OF INSPECTION APPALS �—
Rough Wirir4g? 1 1 .... -- ... --- Fixtures .iS�-7 ------I-
A e OR GATE INSPECTOR
Finish Wiring .�. ' ' NS --
-
xEP[ Motors ......... ... ..
o e ITOR DATE oR
Final
ATE INSPECTOR
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