860 (2) NO. _ STREET LOT NO.
�APPLIGATIQNF0 ELECTRICAL PERMIT
` t s C t CUPERTINO
Date !!!/ 7-1� �`3 9^'0 Permit No. (.0
Application s Or Fee
r a Fo I��ry+tCAof Cupertino for a permit to install electrical
wising and/or fixtures as listed on ttie reverse side hereof, and agrees to install said
wiring-and/oi' fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
J Use:Of Premi
(� / WELEMUCAL
:a Owner /�- /!'f�*��CY� Address,14 � �—- AddressCONTRACTOR, AGENTC . Approve
Phone: OYJ-A ' E(Tpz
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ELECTRIC 'SERVICE NOTICE` o>ilcs .
BUILDING INSPECTOR'S OFFICE ►ram '
nh 1� Y
CITY OF CUPERTINO /�
..........................'�_5o.......`--------- ......; 19' . •;
To
oare hereby aut •ue Oil
th EE Re foAr
OwnerorTenanti i ___e>P
At /Q 2L -- -�-� -- - •............ .. .... ,...'...........
No. of Wires �� ............. Size of Wires.......... Size of Switch �C.�l. •
Motor Load ............................ Voltage ................................ Phase.........................
.... =.,.. : .....-`.
�..
Heating Load ........................ K. W. . .::.:...,�. � ..._ Voltage_ ................................
No. of Meters .... v
Light ... ......._110 .v _
...............New Service........... .....Reconnect ................'
�........... -
Heat ..............220 .....:'.....Three Wire ..................Mote Service ..........
No. of Add. Meters .......... - •„ -.",
Power ........:..... Iove Meter ............ ,
1o4 1/60-500 �jELECTRICAL INSPECTOR