1986 NO. STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT
CI-TY,
LTY CUPERTINO
I�I I n w
Date 195_ Permit No.
rl rI Fee
Applicatiiori is hereby,madeFto`ihe 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, d all other laws applicable thereto.
�
Use of reni
oPih,
Address
Address
ONTRACTOR, AG T Approved
LSCIAI 1 SP8
NEW RPL FEES
A
Size Service Conduit......................Number of Outlets.................. .......... .......... ..............
Size Service Wires..........................Number of Switches................ .......... .......... ..............
Size Service Switch........................Number of Receptacles............ .......... .......... ...../........
Size Sub Peed Conduit..................Number of Fixtures.................. J....... .......... ........
Size Sub Feed Wires..._...............Ranges................ KW.......... . ......... .......... ..............
Numberof Circuits................... Oven .............. KW.............. .......... .......... 11.11.........
Number of Meters........................Signs.......... Transformers........ .......... .......... ..............
Misc................................................Dryers........................................ .......... .......... ..............
Motors.................... HP.................... Phase.................... Permit Fee $1.00
Motors................... HP.................... Phase....................
Motors.................... HP.................... Phase.................... H P Charge................
TOTAL FEES—
RECORD
EES
RECORD C X
OF INSPECTION APPROVALS
RoughWiring................ ............................ Fixtures ...................... ............................
OATC IMSFCCTOROAT[ INSYCCT0*
Finish Wiring ..........9.....�.............-...0111.. Motois _1111 .{{AA .Y. �.. 1 .1.11.............
OATS IMVSCTO4 P1RaI �.. .Yr/SyX.. SCr�!........
OAT[ •.•• IXSPUT011