51189 (15) NO. I STREET LO /
r o_ 4— PPdL1QAfION FOR ELECTRICAL PERM
o ' 69 � CITY OF CUPERTINO
3 U I O LJT — ry 69
4 Date 194� Permit No.
0
_� CITY OF CU'PE INO Fee $ 77//-10< Application is hereby made to the City of Cupertino for a per
to i tall electrical
W = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
r
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
S N City of Cupertino, and all other laws applicable thereto.
z J Use of Premises r
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O �/(J`�
3 a Owner Address
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W zBy Address
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0 LL AGENTa oApprove—U Phone: vI�. State icense:—Jv' —
NEW RPL FEES
Size Service Conduit.............:........Number of Outlets.........._...... .--------- ---------- --------- ----
Size Service Wires..........................Number of Switches...............- .-760------- ---
�q
Size Service Switch............._...-.....Number of Receptacles............ .
V - ---- - -- ---
Size Sub Feed Conduit..................Number ofixtures;.................. ... . . .......... ......410
Size Sub Feed Wires..... ......... _Ranges.....- . ....... KW-------------- ----F
I
Number of Circuits—.,
.............. Oven -------------- KW..----------- --
Number of Meters.........-........Signs.......... Transformers........ ......
.......... ..............
Misr:........ IIZJIP....Dryers------. ---------- ---------- ---------- --/Z-.0-0
Motors-------------------- HP../------------ .. Phase........._....._..
Motors-------------------- HP.................... Phase-------------------- Permit Fee $1.00
Motors.................... HP-------------------- Phase.................... H P Charge................ .... --------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- ---------------------------- Fixtures ...................... ............ ...............
OATS INSPECTOR GATE INSPECTOR
FinishWiring ----------- ----------------'------ Motors ............. ......... ............................
DATE INSPECTOR DATE INSPECTOR
Final ..........................
DATE INSPECTOR