2001 (2) NO. STREE LOT NO. -
P ,ICCAAT-WNTF37'OR ELECTRICAL PERMIT
CIF CUPERTINO
l! AY 2 1963
Date , 195— Permit No.
ClTX �� � � T«t� Fee S
Application i rerch'y a o the'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, and all other laws applicable thereto.
o v
v Use of Premiqpq
c �
a Address /c� �
�" Address
CONTEACfOF, AGENT
�YJ Approved
Phone: /l L e.l^ E IUL INSPlCl1DR
NOVY. RFL FF.Eq
Size Service-Conduit..-_._------...._:Number of Outlets........._.,..._ - -------- ---------- ---- qb
Size Service Wires.............._...._....Number of Switches...._.......... 3D
Size Service Switch------------ -----------Number of Receptacles.._........
Size Sub Feed Conduit----------- -----LNumber of Fixtures.__......_..._.. ----- --------- -----
Size Sub Feed Wires------------------Ranges................ KW------------ ---------- --------- --------------
Number of Circuits.................. Oven ------- ..... KW----------- --------- ----- --- --------------
Number of Meters------------------------Signs- --
-- ---- Transformers........ - ------- - -------------
Misc.---------------------------------------------Dryers. --------------------I . - --------- ----
Motors-------------------- HP-------------------- Phase--------------- Permit Fee $1.00
Motors-------.._-------- HP-------------------- Phase-------------
Motors.................... HP------------------- Phase-------------------- H P Charge-------------L....... . .-
TOTAL FEES— q&
0 INSPECTION APPROVALS
Rough Wiring ....... -- ---- -- - ---------------- Fixtures -------*—------- i..........g......... ....
DAT[ RECTOR �PXCTDR
Finish Wirin ......... Motors ------------- -----------------
------- --- ....... .................
Final ... ... . .
D.11 INSPKCTOR
I, the undersigned do hereby certify A hat`
'I• dm the owner and occupant of the single
family dwelling at 44a&25Z�— �
for ich o am making application to do
work as a homeowner.
I also cer 1 y at I will not hire any
non-licensed �✓ or contractor,
but will do this work myself.
TELEPHONE NUMBER diUNATURE