1792 (2) oZ o c9 S= I QAc c
NO. STREET LOT NO.
Tif
AP,P10V
LKW Ij N FOR ELECTRICAL PERMIT
ICIS �0, ; CUPERTINO
N 1962 �. 1
Date , 19 �-V Permit No. 1 �� Z'
CITY OF CUPERTINO Fee $ —
ApplicAfton 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
City of Cupertino, and all other laws applicable thereto.
v Use of Premises
a
/�/� HGCGI S +O� i.t
Owner Address Z( �r //-'Ad
v
S
Address 1 S" e.�i�ihTf.. �� C
CONTRACTOR, AGENT- "
Vi .Approved
Phone:CO/ 3 2"0 S E E(TRI L vECTO�-
NEW RPL FEES
Size Service Conduit-_-------------------Number 'of t!ets-1-... .... .. -- ---------- ---------- ...... .......
Size Service Wires......:...................Number of, itches--
-------- ----------- --------------
Size Service Switch-_--------------------Ndinb<ir.cif-Re�eptacles............. ..... .
----- ---------- -------------
Size Sub Feed Conduit------:---------..Number of Fixtures`------ --------- -----------
Size SubTeed Wires....................Ranges---------------- -KW.............. .... ..... .......... ..........
Number of Circuits--------------- Oven ....... KW- ------------ ---------- ---------- -------------
Number o f Meters.......................Signs.................... Transformers......... ---------- ---------- -----------
Misc...............................................Dryers.....................:........:---------- ---/
------ ---------- --------------
Motors-------------------- HP-------------------- Phase--------------------
Motors-------------------- HP-------------------- Phase----------------- Permit Fee $1.00
Motors-------------------- HP-------------------- Phase-------------------- H Charge......--------- t.............
TOTALFEES
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- ---------------------------- Fixtures ....:------- -------------------------
DATE INSPECTOR DATE INSPECTOR
Finish Wiring ................ I------------- Motors .............. ......... ...... ......
DATE INSPECTOR IA1EOR
Final J4_:;.2,/
.................
GATE, INS PECTOR
�l • . GAS SERVICE NOT) E . COPY
BUILDING INSPECTOR'S OF ICE
CITY OF CUPERTI O'
n
...7 1...................:".To
19. ./.
You are hereby authorized to conned the GAS service or,. - --
Owner or Tenant,..._-Z
.......... . .............
Ar
- !" ✓. i
- "
-New Service
` No. of Meters."..1......:..- s �Reconnect . -- - "
r -Move Service
No. of Add.•Meters .............. " - Move Meter ..........................
..
/PLUMBING INSPECTOR
nn 6/59.500