1026 NO. STREET LOT NO.
ATf AIPR 2 04
R ECTRICAL PERMIT
1 APR 2 0c1961 Fut
ERT1N0
Date 1
. � Permit No. b 2'
CIT OF CUP.ERTIIV0 Fee S l
Application is hereby made to 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.
Use of Premi �J {/'�/
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i�jy1( .ln.[Aiy KIX.�I 2 i' 4C
a Owner _ Address
4� By. - Address r_
;: .•. CONTRACTOR, AGENT -
Approve
hone:+ ELECTRICAL INSPECTDI '��
.f to y
NEW RPL FEES
Size Service Conduit......................Number of Outlets.................. .:........ ..... ------ ------
' I
Size Service Wires..........................Number of Switches---------------- ---------: ..-------- ----.._..._.
Size Service Switch........................Number of Receptacles------------ ----7----
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---------------------------------------- ----------I-------- ---------
Motors-----------------. HP-------------------- Phase------------------
Motors.................... HP..........--------. Phase------------------- Permit Fee $1.00
Motors-'-.._........... HP------------------- Phase------------------ H P Charge.------------L...."'--•--
TOTAL FEES 7D•. '
RECORD OF INSPECTION APPROVALS
Rough Wiring........TF.... 'Futures '
OATS INSPECTOR
'. +
INSPECTOR . ...
Finish Wiring --------- ----- ...... ....... Motors ----. ------- ---
PATE
. ` INSPECTOR:' F9 ,
IN
lam?.
' DAT[ INSPECTOR.