1236 (2) 0109ro Y7
NO. STRE:T G LOT NO.
ATIOWF'OR ELECTRICAL PERMIT-r,
1! NO`J 21 ` 31OCUPERTINO
Date 7�!_ t'O - ., / Permit No.
Application is hereby made to the City of Cupertino for a permit to install electrical
_ wiring-"n d/o fixtures_as_listed,on_the.reverse.sidfhereof,Mand^agrees` to install said,
t tvinng and/or fixtures'im accordance witk tle}proJistonssof the.Electrical Code of the
-City of Cupertino;and all other laws-appli ble hereto"
� v t
M Use of Prem.
� u - s �-"k ;~���i 5 -+�„K lh. a"``drr.l�y;•Z �t '� � .�
.a 'Own`er. ' �� ."A3dres"..S". _ 'e.'`"'"`_'�• ' 1
By / -Address /
CONTRACTOR, AGENT
/ -Approved
ELE •ICAL INSPECTOR
NEW RPL FEES I
Size Service Conduit-------------------_Number of Outlets........... .... ..2� ...._....�_�,;t'_. �.n
Size,°erv;ce'Wires.........................Number ofSwitdies_...._.._.... .y.y ''� .
.�::?-.`:./.A
.... ....-...
Size Service Switch........................Number of Receptacles------------ ------ - ....------ .....:
Size Sub Feed Conduit.'...............Number of Fixtures.................. .. .2.......... ...........20
Size Sub Feed Wires....................Ranges------ ------ KW-------------- ---------- ---------- -...---.7.5
- Number of Circuits................... Oven ----- ...... KW-----::.,; ---------- ----------- ..Numberof Meters......:..................Signs.......... Transformers.: :.. L ,
Misc.......-----------------------------------------Dryers...1--------------------- ----------
Motors
.....c: ..:' - -- - .Motors...... ------------ HP------------ Phase-----------------
Pe�m �Eee $1.00
Motors-------------------- HP------------------- Phase----------------- .,i ' '.w..
Motors------------------- HP------------------ Phase------------------- H P Charge:_':.'------ ---�---------
TOTAL
-- -5
Y'.•
TOTAL FEES I L�G'd t,
.D .�/C INSPECT_ION APPROVALS
Rough Wiring*C Fixtures ....: .
PECTOR - INSPECT.O.R
Motors ------Finish Wiring ................ ----
OLTC INSPECTOR Final.:74'_ R
...-
DST.. IxsrecrDR .1,:
ELECTRIC SERVICE 'NOTICE fCF
f
BUILDING INSPECTOR'S OFFICE
/11000 CITY OF CUPERTINO
........... '-...--------- --....... 19G-A.
S• ry,� C�L�. '*",�'•r
Owner or Tenant ....
����auth ed to connect the ELECTRIC service
`'y�,`,•-,
At
u
No. of Wires ti.7.--/ -..... ... Size aC - "Siie'oF=Switch --- - -
..�
.-
MotorLoad'--'----.....----..._ Voltage ................... ase;....,,:"':::":•:.'�:':.
'. --- ---- ---..-_ Vol'..�n
6
Heating load :'-...--...--......-- K. W. ...----.... -- tef�e,"•,�,. .:,
S
' .:.._---- -_110 _�.. .... New Service,...f► • rReconnect .. ....- .._-
No. of Meters -_/ - .'� .::.....,. c::a--....._.
_..-..._
Light .-....----_220 ..... Three Wire ------_�.._...--.Move Service;:•......--
No. of Add. Mc as ..;e - .,. .
Heat
I oweree
.......... .D' ete[9........
tt ��gf 's
�j-
ELE TRICAL OR��CT
04 7/61J f0
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