125 (2) NO. STREET t LOC NO.
2 1 S 4 -
APPLICATION FOR ELECTRICAL PERMIT
VITY OF CUPERTINO
Date , 195 Permit No.
S�
/ s �
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 Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Premises
u i
a Owner ✓�/�n/�/���/� _ A2dress G
ro By u JY�i ii. �. Address
65 CONTRACTOR, AGENT t
Approved
Phone: ELECTRICAL INSPECTOR
NEW RPL FEES
Size Service Conduit./ Number of Outlets-.,,
......I....- /---
-- -- ---------- --------------
Size Service V -1---.---Nwnber of Switches----------------- -- ---------- -
-6
Size Service Switch......./.........d
.......Number of Receptacles..... -- ---------- --v11.
Size Sub Feed Conduit------------------Number of Fixtures....-............. .1a.. ---------- -/Ye"'
Size Sub Feed Wires...................Ranges-----------/-- KW-------------- ---------- ---------- --------------
Number of Circuits-.._......... Oven .......1..... KW.............. .......... .......... ..............
Number of Meters---.I................Signs..........//Transformers--.---- ---------- ---------- --------------
Misc---------------- yers---------------------------------------- ---------- ---------- -----------
Motors......2--- Phase-------------------- el//
Motors.................... HP ................... Phase.................... Permit Fee $1700
Motors............ ....... HP--------------------- Phase-------------------- H P Charge---------------- --------------
TOTAL FEES 71�
CO 7
kNSPECTION APPM
pJi,Lp/ 1 LP TOR
Rough Wiring ........ Fixtures
To
Finish ..... otors ....
ATE INSPECTOR Final ... le
2. INLPLCTDR
ELECTRIC SERVICE iTICE 6i1cL '';w
,r. �SoPrt �d*
BUILDING INSPECTOR aICC•
CI1{4Y 017 CUPERT.ik
J ---...... /f.. ..- .at..._.................. 195..?
T
You are hereby au�thgQrizedl connect the electric✓service for7� '
Owner or Tenant ..C.C/
----------------------
p p'? o
At -.,�0/ 0.......( �cYQ�i/..C7�fisl �..... -- ......................
No. of Wires ...,, ............_. Size of Wires ...p—------------- Size of Switch Ai�as.Q .}?
Motor Load ............................ Voltage ........................ Phase....................................
HeatingLoad ............ ........... K. W. .................................. Voltage ................................
No. of Meters_. Lig
_. ht................. l lU..'. .....New Service.....4t........ ReconnecL.y-........._:..
.........
Heat.................. 220_,�--------Three Wire....-..-.-..------- Move Service............
No. of Add. Meters............
Power_............. Three Phase.................. Move Meter..............
104 2/59-250 ELECTRICAL. INSPECTOR