141 (2) NO. H'I'S T E T�� G' LOT NO.
2 1 S 4AP, - CATION :FOR ELECTRICAL PERMIT
rR n -`- •-�"x CTS OF CUPERTINO
Date , 195 Permit No.
ryy /� Fee$'
ApplicationCi hereby�rria`de)tolthrtAity of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
N wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
v . City of Cupertino, and all other laws applicable thereto. .
U Use of Premispq At
a OwnerA✓//A�� Mess Q
v
F9 By �z6 �-' '� Address
CONTRACTOR,-AGENT,;
4. Approved
Phone: - ELECTRICAL &sPEcro3t
4w •RPL �Ens
Size Service Conduit ...... f--------Number of, Outlets......-..__..... ...........
Size Service W .........Number: of. Switches. - .. ..........
Size Service Switch..--10e)—.......Number of Receptacles------------ -
. .......... ..............
Size Sub Feed Conduit................_Number of Fixtures.................. .Ili... .........I-
Size Sub Feed-Wires..._..............Ranges............-- KW--.._.----- .......... ....I------ -- .1.......
Number of Circuits--------------- --- Oven ......... KW-------------- ------ .......... ..7
Number of Meters......./,r..............Signs....!..... Transformers.--... ......_.. ........... ...............
Mist.---------------- ers.. ---------------------------------- ---------- -
Motors.—A..........::- --ii�&"ir.'Phas'e----------------------
Permit Fee 4.00
Motors.................... HP/----------------- Phase........_._.......
Motors------------ HP-------------------- Phase-------------------- H P Charge....::...... ---------
TOTAL FEES
INSPECTION APPR V
Rough Wirin ... .... Fixtures 4,:0 .. --.......
EC' IVIPEROR
Finish Wiring�
........ otors
.;;. ..........
ATE INSPECT,
-1 W.T.
tFinal ...i ...
GATE INSPECTOR
ELECTRIC SERVICE:NOTIC OFFICE
BUILDING INSPECTORV O?, I
OPY
CITY OF CUPERTIN0 ,r
� 1
1 ,
.. ....... . 444 .......s.......
To
You are hereby authorized to connect t Electric service for
Owner or Tenant r� �_f'r = = _ �- �•" _
...r....................:.c__.. .
At --
. .........
......:... ......
No. of Wires ... ............... Size of Wires ........ ......... Size of Switch
MotorLoad ............................ Voltage ................................ Phase ...................................
HeatingLoad ........................ K. W. .................................. Voltage ..............----..........`--
Light ............_110 .-./.......New Service ----------------Reconnect ...._..........
No. of Meters ..../..............
Heat ................220 .....Three Wire ...._.........._Move Service ..........
Nn. of Add. Mcrers ..._.....
Power.............. _,\ Three Phase...................Move Meter............
p i'�.lDL•x."�.•-
104 r/59-250 ELECTRICAL INSPECTOR
C.-