801 (2) NO. STREETLMNO. �•� l
b' -APPLICATION AEL"ECC--A'L PERMIT
CITY OF CUPERTINO
Date �t -fi// /.Sd 191Lr) Permit No. "' •� I �-
r
4Application is hereby made to the City of. Cupertino for a permit to install el"- ical
4 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.
a Use of Premigeg
;.a Owner � ��p� � �--r"->�A'ddress "y� • " •�-
v
By Address A 1
CONTRACTOR, AGENT Q �
Approved I
Phone: C//� G3�l ELECTRICAL INSPECT IL
"i�yo r
or NEW RPL FEES
Size Service Conduit.... ...�.Nu B;r of Outlets.._....... ------ -,I .......
S ize ----------
." �eivije Wires......09, umber
of SWitches-------------- '00
.Size Service Sv;itch....
........Number of Receptacles......_.... . .. .......... ......,.......
Size Sub Feed Conduit...............:.:quri&ijof Fixtures................-. ---------- ---------- ------------_
Size Sub Feed Wires...... ............. KW -5
............ . ..*------- ---------- - 2-?
Number of Circuits................... Oven .........: KW------------- ---------- ---------- -
Number of Meters........................Signs.------ __ Transformers........ .......... .......... .-------------
I
Misc..................................... ....
.. .......Dryers........................................ ...... ..I----------1/57---
Motors---------------_- HP.................... Phase-------------------- Permit Fee $1.00
Motors................... HP.................... Phase--------------------
Motors...................... HP.If':............... Phase.................... H P Charge-------------- ---- ---------
TOTAL FEES
RECORED,j;(ODIF INSPECTION APPRS e SI
-0
.......... .....
.......... ............. Fixtures D;Y%
Rough
.ro�y INSPECTOR
lip
X&4 otorS .. _ / H
I..................... ......
Finish Wiring 'P.iv
!);TE INSPECVOR
Final .... ----- ................---
DATE t4spECTOR
ELECTkIQOERVIdE NOTICE OFFICE
copy
BUIL- INSPECTOR'S Q'
A r;FICE
CqV OF CUPERTINO
............
To4-0............................... 196.1-
-Yon arch;reby author toy onnect the ELECTRIC service for
Owner or Tenant ---- ..........
.........
At-----:/............ ... ......
No. of Wires ......... Size of Wires --------
Size of Switch
MotorLoad ................... Voltage ................................ Phase..----------------------------------
HeatingLoad ..........:------------\K. W. .................................. Voltage ................................
Light ..............110 ................New Service�- ............Reconnect ................
No. of Meters ... ............... Heat ..............220 ................Three. Wire ..................Move Service ..........
No. of Add. Meters ..........
Power .............. -ThrFe.Pha C).................Move Meter ------------
- - - -------------------------------------
ELECTRICAL INSPECTOR
104 1/60-500