1939 (2) --L'2 �I
NO. 5"rREET ` LOT NO.
cT 6§TOM ELECTRICAL PERMIT
Inp� u
SMA- � T �IL CUPFRTI[VO
R 8
Datetn%d� '� permit No.
r G��r
61�� !�V
Application is hereby made to 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
C.� City of Cupertino, and all other laws applicable
/thereto.
v Use of Premises
c
aOwn x >K Address
By Address J 1,
NTRACTOR, AGENT
_ _ Approved
Phone: ECIRICAI INSEECrOl
/ /0 _0 NEW RPL FEES
Size Service Conduit_.,.../.e......Number of Outlets._............... . .. T
Size Service Wires....:#Z.---------Number of Switches-----_... ..... c ------ ---_-----
Size Service Switch..___.......... ......... ........_L ...
�� Number of Receptacles------------ -Z�
Size Sub Feed Conduit..................Number of Fixtures------------------ -- -- _........ ...
Size Sub Feed Wires.-'- ------------Ranges.......Z.... KW.............- --------- --------- -
Number of Circuits........7------- Oven ---/------ KW----------- --------- .
Number of Meters....... -------------Signs---------- Transformers-------- ---------- ---------- --------....-.
Misc------- ---- ---------------------Dryers..-'1------------------ ----...------- ---------- -------- ------- ------
Motors-.. ---------- HP.- Phase--------------------
Motors............--.-. HP-------------------- Phase..........-..._... Permit Fee $1.00
&0H P Charge......... 0
...
Motors. . HP. ... Phase-........---- .-..... .. (...--
TOTAL FEES
O D OF INSPECTION APPROVALS
Rough Wirin - .—` .. Fixtures ._..
l/
Oy�y 6CIOR GATE INSPECTOR
Finish Wiring'3/7"3�/ Motors
...----------- - -- -'-"--------.... ----------- —"-
DAT[ INSP[CT.. v n IIMS�TC.CTOR
Final /_� _^.. .�:�--'`'"-'------ ---
DATE INSPECTOR