1560 (2) o s-s i& ,�,eIra D�f I,
NO. STREET LOT NO.
1
APELICA :I. N FOR ELECTRICAL PERMIT
® C OF CUPERTWO
DateJUL 121962 S6o
— 195_ Permit No. �
Fee S
I� Apel ffilnQferVJPF ' ��City of Cupertino for a permit to install electrical
wising and/or I�tures as Iste on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Elul�ofthe
City of Cupertino, and all other laws applicable thereto.
u Use of Premispq
C
OwnCL
B : "ed caAddressy /� tCONTRACTOR, AGENT Approved
Phone: I °/// k/�7�� E✓ECI CAL INSPECrOl
i NEW ]FIRE FEES
Size Service Conduit----------------------Number of --es........_..------ --- ---------- --------- ----------
Size
--- -------
- 04"'
Size Service Wires------ ----------Number of -s -------------- ---------- --I------- --- ----------
.......... S""'
Size Service Switch...._------------------Number of Rcept c ---------- ---------- --------------
Size Sub Feed Conduit------------------Number of Fixtures.............._.. -JF-- ---------- -----
Size Sub Feed Wires-'------.........Ranges..------------- KW........._... ....._... --- ------ --...--------
Number of Circuits...._... ........ Oven .............. KW...---------- ---------- --- ------ --------------
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 OF INSPECTION APPROVALS
RoughWiring.--............ ---------------------------- Fixtures ---------------------- ............... ............
DATE INSIECIORMotors DATE .IN-5,I,r,CT"a,R--------
Finish Wiring ---------------- ---------------- ..... ---------- --------- .......
-- - " '
DATE INSPEO-0. OArt INSPECTOR
final -------------------------- ---------------------------
DATE INSIZU01,