517 (2) NO. STREET LOT NO.
r1l
,OR, ELECTRICAL PERMIT
I OF CUPERTINO -
9 6� , 195 9 Permit No `� /
Date . ry
AppUT" r pFb 41�t`C'it Fee
g�V/n iUreb UR� y 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.
u Use of Premi
c
a Own L. Address;Ofzo
By Address
CONTRACTOR, AGENT +�f
RL APProve
Phone: ;� bp"ICAL INSPEC701t
NEW RPL FEES
Size Service Conduit--- `.y..........Number of Outlets................. . 3a
Size Service Wires-----.----- .--------Number of Switches................ ...
Size Service Switch... ..,�A..:.Number of Receptacles............ d
Size Sub Feed Conduit..................Number of Fixtures.................. .......... .......... .............
,z
SizeSub Feed Wires-------------------Ranges................ KW.............. .......-- .......... ..............
Number of Circuits................... Oven .............. KW---------- ---------- --------- ------------
Number of Meters........................Signs---------- Transformers....---- ---------- ---------- ---------_-:-
Mise...... -v-:-..... ..------ Dryers...-------- ------.....__......_... .......... .......... ._............
Motor HP.. Fj..... Phase....-.-..._........ Permit Fee $1.00
.....
Motors...... ........_ HP........----------- Phase...-------------- rr
Motors.................... HP-------------------- Phase--------------------- H P Charge---------------- ....BJ...
TOTAL FEES • ��
RECORD OF INSPECTION APPROVALS
Rough Wiring.......-........ .................---------- Fixtures --- ------------: ...
.....
------....._....
DATE INSPECT OR:. DAT E XS;ECTOR
Finish Wiring ..--........ otors .... ...................
..
DATE IX9 P ECTOR 2 ' P C OR
Final .. .. ....... .� ....�.. ............. ..._.
D C
IN