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43
-
NO.
R ;2 C' RICAL nPERIaIT
(MAR 7 1961 OF CUPERTINO
DatcGIT�fCU 195— Permit No. qq C)
��� ��11! Fee r(:�)5 70
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 tier f, and agrees to install said
wiring and/or fixtures in accordance with the provision ( ,e lectrical Codethe
City of Cupertino, an all other laws applicable there . ' H"D9Q
i
v
Use of Pre �U M O P C )
mi � 1 r ti amR R e r
Xi/ SCril7ih GG_
Owner Address
Address'.
q, CONTRACTOR, AGENT
//(�����t///��/ �[ n 4 . •y-_..' Approve
/Phone: "' �-/-� �.�. .�'- %%P I'i -. .,[ELEM ICAL'u SWECM
NEW RPL FEES
Size Service Conduit..------------:::-----Number of Outlets---------- .._ .-------- - ---
....L..-_..-0-
Size Service Wires..........................Number of Switches..... ...
.... ---------- .
Size Service Switch Number of Receptacles------------ ---------- -------- - ._-----------
Size Sub Feed Conduit------------------Number of Fixtures----------------- ---------- ---------- --------------
Size Sub Feed Wires...................Ranges---------------- KW-------------- --------- ---------- --------------
Number of Circuits................... Oven .............. KW------------- --------- ----------
Numb Meters_............ .........Signs..-....--- Transformers- ------ .......--- -- ----- ;
oo Finn .C�q �
Misc.-- ----2.V.1.�Q .....A!`l�rj ----------------------tom,....-- - - - -------- —-----—
Motors-------------------- HP-------------------- Phase----------.----- .
Permit Fee $1.00
Motors-------------------- HP.....:.......----- Phase----------------
Motors--------------------. HP-------------------- Phase-------------------- H P Charge---...---------I
C-2 7 t7
` — _._,—� TOTAL FEES i
RECORD OF INSPECTION APP,ROVAT.S'- , a
g - - - ...
Rough Wiring .----------c...... `- Fixtures ....----- '• ..it....'---'
g
DATE INSPECTOR r-P ' -- RATE -INSPECTOR.
'+. I ,. .
\
Finish Wien ......-`...... . . - Motors ......:....... --------
Ti
.. .:
Wiring
GATE INIP[CTOR -�� OATL1� - ) IMSP[LTOR\ '"'\ t ✓^
IZ•l•'61 tJ O. d SQ k .T \. lr07
rT Final
{til RS�KC Jt'4-WV •J 24 4 fl
OATC
(�"�v� � iXSP[CTOH I.M \ 1 '�
I, the undersigned Iohereby c ;,,rtify t-1 AV I.ei i ,, c
/2eh�e a occupant of the single £'e/injily di;'elling It
111��U I d+ e J Q Js C12ee 14� arch I s;
making
application to do r 'L-o7ork as n home owner.
I alsc certify-,the.t,I tvrill not hire*,my non-licensed:
L6,
El 2Q i rt ic2 or contractor; but'-Will do this work myself.
TIIEPHO •,E ,RJIBFR — SIGNATURE