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436 (2) NO. STREET LOT NO. APPLICATION FOR ELECTRICAL PERMIT t ITYF C-UPERTINO Date Permit No. / •Y•, yiYt� Fee t Application is.hereby made to the City of Cupertino for a permit to install electrical wiring and/or fixtures as listed OnhQTrjNnQe side hereof, and agrees to install said e wiring and/or fixtures in accordance with the provisions of the Electrical Code of the City of Cupertino, and all other laws applicable thereto. V1 Use of Premiseq u J .:a Owner i 1,,44 /f Address1431.1- (FLLaV4 M By , '+� �iT . �� Address COrNTAACTOA, AGENT ,7 G �O/ Approved Phone: — ELECTRICAL INSPECTOR NEW RPL FEES Size Service n uit...z r of ..........Numbe ...1__ -O Size Service Wires----"f- --------Number of -------------- ......... .......... .............. Out""j Switches Size Service Switch,&.029RAumber of R�cep ac es............ ir... .......... ....!-------- t i,4 Size Sub Feed Conduit..................Number of F ies ---------------- ----I---- ---------- ---- SizeSub Feed Wires....................--..........Ranges.............. KW.----------- ---------- ---------- -------------- Number of Circuits._......... .... Oven .............. KW-------------- ---------- -------- -- ----- -------------- Number of Meters........................Signs.......... ransform ------------- ._;rs ..... .......... ........ Misc------------------------------------------------I ------- -- ----- ---------- Motors........... ........ HP.................... Phase------------------- Permit Fee $1.00 Motors-------------------- HP.................... Phase-------------------- Motors-------------------- HP-------------------- Phase-------------------- H P Charge---------------- ---------- TOTAL FEES —J rLQ - RECORD-OF U5R4C7l0N APP 0 S Rough Wiring ... .. Fixtures --------- .. TOR Finish Wirin ... ...... Motors 1� SP OR VA E INSPECTOR Final ..... . ......... .... .....------ DATE INSPECTOR