1710 (2) CRI YNR -10- QC-A .
NO. sTREET LOT NO.
TION FOR ELECTRICAL PERMIT
CAC OF CUPERTINO
Dace ,9 CCT 10196a ( 7 1 o
195— Permit No.
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PpS�`6, klli Aj�4Nad kTbc y pe per F
A ^ Tin ere t t e Pty of Cupertino fora 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 ace prdance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Prcmisr`�
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a Owner Address ..
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y/ CONTRACTOR, AGENT
r��sr� Approved
one: �r� !7 EL ICAL INSTECrOR
NEW RPL FEES
Size Service Conduit-------A?.....e.....NumEer' .of outlets..-.---..----- ---------- ---------
.................. .......
Size Service Wires-----X---------------Number of Switches....._......... .._..... . ....... ....... ......
Size Service Switch...,--—0._-----Number of Receptacles------------ ---------- ---------- --------------
Size Sub Feed Conduit------------------Number of Fixtures...._------------ ---------- ---------- --------------
Size Sub Feed Wires-........._......RangesRanges................ KW.............. .......... .......... ..............
Number of Circuits------------------- Oven -------------- KW------------- --------- -- ------ ----- -------
NumSr f Mete(r.:s,........ .................................Signs---------- Transformers........ .. ...... ........ ----
-- -60
Misc....... 0Z.... . . Aryers----------------- -----------_-------- --------- ---------- - -- --------
Motors----------- -------- HP-------------------- Phase...---------------- Permit Fee $1.00
Motors -------------------- HP-------------------- Phase--------------------
Motors-------------------- HP-------------------- Phase.. ................. H P Charge----------------I------
TOTAL FEESL-------LZ�f�
COR SPECTION APPROVALS
Rough Wiring.-_ - - - Fixtures ----------------------
----------------------------
DATZ PI TO
... . .........
- -- -
Finish Wiring ..... ------------ Motors ------
ATE '".1ECTOR ------
Final ILI ....I-------
OAT[ IKIPICTOR