1980 (2) NO. . STREET LOT NO.
APPLICATION FOR ' LECTRICAL PERMIT
CITY OF C PCRTINO'
` FS U
:Date,•; 195_ Permit No.
CZ
Applid'atipp is reb made to the it of Cu.actino for'a permit to install electrical
..+- or
wiring andror,fif isfgd:+bpi.' 1. Aheri ,_and5ii&lees to install said
wiring and/or fixtures mn �. Ord a rovisions of'the Eiedrical Code of the
City of Cupertino, and all other laws applicable thereto. "
adl Use of Premise
o 1
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�.oR ! ►eerti � Address A& �
` B ByAddres���`sP 7�n
h CONTRACTOR, AGENT
Approved
one: LE L INRPlL7O�
'L
i NEW RPL FEES .y
N
�
Size Service Conduit...................._Nmberd u s........._....... .......... ........_ ---- ---------
Size Service Wires.........................Number Sa sties..._..........: .......... ........_I.........
.-...
Size Service Switch-..._..............'._Number-of eceptacles------------ ---------- ---------- --------------
Size Sub Feed Conduit..................Number of Fixtures------:----------- ---------- ---------- -----------
Size Sub Feed Wires....................Ranges................ KW..........--- ---------- ---------- -------------
Number of Circuits_................ Oven ------------ KW------------- ------- ------- --------------
Number of Meters........................Signs---------- Transformers........1....
...... .......... ..............
Misc_--------------------------------------------Dryers...-------------------------------.. .......... .......... ..............
Motors-------------------- HP-------------------- Phase------ ------------- Permit Fee $1.00
Motors.................... HP------------------ Phase.........--------
Motors.................... HP.................... Phase----------------- H P Charge................ .........
....
R TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring................ -------------_------------- Fixtures ...................... .........r...- ---------
DATE INSPECTOR OAT[ I XSP[CTOR
Finish Wiring ...._........-- ......................... Motors -...:�....__.- . - -
DATE INSPECTOR • /' O.ATy y1XSPEOTOR
Final
DATE INSPECTOR