127 (2) s ' TL
T No. •
2 1 5 ¢ APPLI,�A, ION FOR ELECTRI AIL PERMIT
TY OF CUPERTINO,
Date ✓� , 195 Permit No. P"
'v
Fee ti /
o
Application is hereby made to the City of Cupertino for a permit to install electrical
\N1 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
�`r City of Cupertino, and all other laws applicable thereto.
x Use of Premise- / fir,
u P
a Ownerf'�//� � � ,cf ry,A�d3ress d
hBy .>!s1 Address
CONTRACTOR, AGENT
Approved
Phone: EGRC7RIGIL INSF90Oa{
NEW RptIq^:pE23
Re
Size Service Conduit.... . ......Number of Outlets................. .. .......... .
Size Service V :
A7.......Number of Switches.......
Size Service Switch...../.,Ad .....Numdr of Receptaco,
,=/.. #
.. .......... •...........
Size Sub Feed Conduit.................Number i.:3... .......... ...
Size Sub Feed Wires....................Ranges.... ...... KW............. .......... .......... .............
Number of Circuits.................. Oven .---Z•--•---- KW...------.
Number of Meters..e.................Signs.................... Transformers.....
Misc............... rs ................................... .......... ---------- ------
....Myers.....................................--
rs Phase
Motors........... Phase....-............... Permit Fee $1.00
Moto ....Lo......... FIR.................... Phase...................
Motors-------------------- HP.................... Phase.................... H P Charge-............... .............
TOTAL FEES-
0 MBPECTION AP 74004
Rough Wiring Fixtures N.
0
--PTO 1.5 NO,
Finish Wiring ......
PATE INSPEC on Ax an
........ .. ...........
TS on
. X.!(...T
0
EL CITRIC SERVICE ICE CFFICE
COPY
PUYLDING INSPECTOR'S- F I
CITY OF CUPER [NO
C i
........... ........ .... . 9.6-Y
...................... ..... .......
To
You are hereby aut iz d o connect Electric serviceor
Owner or Te ........ . .. .................
At
No. of Wires ......................... Size of Wires ... ............. Size of Switcfi./W.�w
MotorLoad ............................ Voltage ................................ Phase ....................................
HeatingLoad ........................ K. W. .................................. Voltage ................................
Light
No. of Metes ..... ..............110 .&1........New Service ....`.....Reconnect ..............
...............220 ......Three Wire ..................Move Service ..........
...........j
Heat
No. of Add. Meters ..........
Power.............. bree Phase ................Move Meter............
........... . .. . ..... ..................................................
104 6/59-250 iTCAL INSPECTOR
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