572 (2) &-7-7.5�
NO. STREET , _ LOT NO. '
APPLICATION FOR'ELECTRICAL PERMIT
�.o CS .Y
GITY'OFCUPERTINO
Date �Ro '+J 'J niiEffC�� 1 159 ""r1�9" 5 ' Permit No.
A,
\ ._ Fee
Application is 1`reby IbM toItl � cy oP,Cupertino for a permit to install electrieal 9
wiring andl/Pflxtures 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, ,aandn�d all other laws
—applicable
�thereto. '
Use of Premises
c /
Owner Address
14 By /' Address
65 �/ CONTRACTOR, AGENT Approved_ �
Phone: ELECTRICAL INSPECEOR
r
!
\ \ \
\ \ } ) \ §
Si +
\ j \
} Z )\\) \ }
• _ i,Kr
t."l. ELECTRICS
ERIC TICE
BUILDING INSPECTOR'S FO ICE
. r
CITY OP CUPERTIN
/ / 1
o .
You are hereby a razed to connect the e tric cerv�ii le f/oy
Owner or Tenant `.... .:3.. ---1,%----;— n•G- %r
/.......__�...�............:........Y.f:... .. ....._...................._..........---
/9 /� .. r /�°�F/ �'�-.•rte
No. of Wires�..:....._............ Size of Wires ......�%............. Size of SwitchSE.:�'�..f'!��
I .
Motor Load Voltage .....----...................... Phase..------....................-----..
HeatingLoad .............-------- K. W. .................................. Voltage ................................
No. of Meters...
' Lig
.-.- _--
In................. I l(/.-r.�......New Service.................. Reconnect..................
�.. ....
HeaL................. 220............Three Wire................... Move Service............
No. of Add. Meters.._.........
Power............... TI ree' se.._..........._ Move Meter..............
........ c.........................................---..........----.....---..............
U04 2/59-250i ELECTRICAL INSPECTOR