121 (2) �.. %NO. STREETI � LOT NO.
2 1 4 APPLICATION'FOR ELECTRICAL PERMIT
CITY OF CUPERTINO
Date � - 195 Permit No. _ /52
Fee $
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.
v Use of Premises
u � i
a OwnPrjl'71��1i/, (��l/e��i��i ..t.r�—eY/ltYlC9�Address J 1
By Address o
CONTRACTOR, AGENT
Approved
Phone: ELECTRICAL INSPECEOl
NEW EEL FEES
f I 1 11
.......... ./
. ..........
Size Service Condduit ......X�'......Number of Outlets.-, ------
Size Service Wires...�.................Number of Switches------------ ......... .
Size Service Switch....2�e' Nj
C ........Number of Receptacles.. ------ ---------- ------------
Size Sub Feed Conduit..................Number of Fixtures----------------- /IY j
--- ---------- -----!.:......
Size Sub Feed Wires....................Ran es...... KW------ --- ---------- ---------- -----
Number of Circuits................... Oven --.-/......... KW-.----- - ---------- ---------- ---
Number of Meters....../...............Signs.......... Transformers........ .....----- --------- - -----------
Misc................ ---
HP ............... -------- -------- ------ -- ------ -- ------
Phase.........------- '�
Motors.._ .��w' ;::;i;;... Permit Fee $1.00
Motors.................... FlPo��. .** Phase......... H P Charge...._....._.. ---- ---------
Motors.................... HP.................... Phase------------------
/" el
TOTAL FEES
RE ?J0 SPECTION APPR V
Rough Wiring. 10 .. -- - --- --- Fixtures ...4P
---- ----------------
C'0.
PO
MIE
Finish Wiring . . .... Motors . ---- -- ----
MT. INSPECTO InTa
' Fmal ... ........
DAT[ (�� IKSPICTOR
ELECTRIC SERVICE (� dfli;E °oP;F
BUILDING INSPECTOR'S 11 61,CE
CITY OF CUPERTI
` � J
----------- .. ..... _..., . . . _........... 19
To
You are hereby auth m
'zed to connec cc service for
I o
Owner or Tenant _. .. t. , i{/- . .CQIGf/At
._
d d
...............
No. of Wires .... ............. Size of Wires .._.. .............. Size of Switch ......................
Motor Load ............................ Voltage ................................ Phase ....................................
HeatingLoad ........................ K. W. .................................. Voltage ...............................
' Light ..............110 ............ New Service ..v._....Reconnect ................
No. of Meters ....f._.._.....
Heat _..............220 _L.......1'hree Wire ..................Move Service ..........
Nu. of Add. Dieters ----------
Power -------------- 'Three Phase_................Move Meter .._........
I
-
.. . . .................................................
ut4 6/59-250 ELECTRICAL INSPECTOR