1311 (2) oto12
NO. a,
STRa97 IAT NO.
�.
•APPLICATION FOR ELECTRICAL PERMIT
Q CITY OF/CUPERTINO L.
Date O 1942 Permit No.
S Fee + a,
Application is hereby made to the City of Cupertino..for a permit to instalLelectrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or figures in accordance w'lr the provisions of the Electrical Code of tho
City of Cupe.4ino, and all other laws applicable thereto..-v.
4' A
51 Use of Pr emisesCt
e �
u
iOwner Address
lle"RY / I Address .«
CONTRACTOR, AGENT ��'
�r , 194o�—J�i2� APProved �
Phane: RLR Gi MRTRC7ox
J
e
kZ>,;#fNRW RPL FEES
Size Service Goninit....7i :.............Number,of OnINsr--- ...... N. ........ .....
Size Servi6e Wires..... ..:.4„........Number of Switches................ �.... ..........
.. :3
Size Service Switch....... ............Number Number of Receptacles............ ;.21... .......... .....20
...........
Size Sub Feed Conduit....&............Number of.Fixtures.................. .1.... .......... ..
SizeSub Feed Wires=................Ranges................................ KW............. .......... .......... ..............
Numberof Circuits.................. Oven .............. KW.------------. .....---- .......... ..........----
Number
......... ..............Number of Meters.......................Signs.................... Transformers........ .......... .......... ..........*---
Misc.................................................Dryers........................................ ........... .......... ..............
Motors.................**' HP.................... Phase....................
Motors.................... HP.................... Phase.................... Permit Fee $1.00
Motors..................... HP.................... Phase.................... H P Charge.....------.....
TOTAL FEES
A "-0 wspwriON APPROVALS
Rough Wiring..........
..... . . ................. Fixtures ........--...---••---I--....---------------------
Finish Wiring ......DATE...... ........IN.SP.ECTQ.N... Motors ..........DATE......... INSPECTOR
..... ........ .. .....
OAT9 INSPECTOR Final
SIT. INSPECTOR
I,. the tindersned• do hdrey certify that
- - 2 ism owns and occupant f the 1-rale
famil
we 3.
at �GL��- ( fri✓
for �h Ie am King application
work�as a homeowner.
I also certify that I will not hire any
non-liodnsed• or con-
tractor, but will do this work myself.
de% ` 0 y aIf}N 'U