1111 (2) , /A , ZIIM,4
NO. STRECT LOT NO.
ELECTRICAL PERMIT
PERTINO
Date ' O h2 ,-,. Permit No. - I I /I
ry Fce I q-3S
Application 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 ElectricdFCode_of'the
City of Cupertino, and allother-laws-applicable-thereto.-'-�"".�•.:.
.•: a•,
; 3 --
� 1 q•
v Use of Premise, /t"f�' ^:s y'�e`•rf=P a'� t- `�-
'a .:Owner ( (tyl�"C/A! iAddress /
C By • ,•Address
.L� CONTRACTOR, AGENT .. pp A rove O
/
I� n (--2 - 6 O I 7 ELECTRICAL INs croz- /
NEW RPL FEES
Size Service Conduit----------------------Number of Outlets........._....... ..1 ------ .....�n.X-o
.....
Siz&'Service Wires.............:............Number of itches-------- --------
..... ....Z,
3
Size Service Switch:......................Number of Receptacles............ .:....... .......... ...
Size Sub Feed Conduit..................Number of Fixtures.........:..------ --
---- - ---------- -----
Size Sub Feed Wires-------------------Ranges-----z----/.... KW........------ ....... -- ---------- --I----,7-5
Number of Circuits_....----........ Oven. ------ ..... KW-------------- ---------- --- ------ ---------
Number of Meters........................Signs.......... Transformers-------- ---------- ---------- -----
Misc------- ---------------.Dryers------------------_------------------ - -------- ---------- ---------
I otors---f Permit Fee $1.00
M HP-------------------- Phase--------------------
Motors.................... HP-------------------- Phase....................
Motors.................... HP--....----------- Phase. HP Chirge--------------- 11-ci
TOTAL FEES
INSPECTION APPA
Rough Wiring ......... Fixtures/4,
A I T
Finish Wiri4 ......---IlIlWotors
sere IMEMSPEITIOR
Final ...... ...... ..........
r.
DATE !SPECTOR