1065 (2) �T J0. ee
NO. STREET L NO.
�1
PI rr�• I{ ELECTRICAL PERMIT
C[���QP'CUPERTINO
JOH 23 1961 1114=L�l+LL�ll�ii�11 / a b
Date , 195— Permit No.
i ab Ln
4 �RIFee � �
Applr'li� js cby e o t e CNOity of Cupertino for a permit to install electrical
J wiring and/o;fixtures as listed on the reverse side hereof, and agrees to install said
�Q wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other lams applicable thereto.
Use of Premi<es
;.a
VAL
Owner L O- d
By X "
Address
x�1fiMTROCTOR��EC/T.� ,�;1 7 1 ��r •
I , ,. a ., iApprove _
Pht � I ELECTRICAL INSP 0701 /�\/
I NEW RPL FEES
Size Service tt
-NIr COutlets--...... --- --- - --- - -- ----- ----
Size Service Wir -- ----------------------Nurnbei 03' Switches..-------- - -- --Size Service Swih ............ .........Number Receptacles--------- ---------- --- . .. . ..............
Size Sub Feed Conduit------------------Number of Fixtures.................. .......... .......... ..........
Size Sub Feed Wires....................RangesRanges---------------- KW----------- ---------- ---- ----- --------------
Number of Circuits------------------ Oven -------------- KW...----------- ---------- ---------- ---- .........
I — ej(D
Number of Meters.................._-...Signs..._..... Transformerc�)
-\� *--*--*--- ------- - ------------
Misc------------------------------------------------Dryers---------------------------------------- ---------- ---------- --------------
Motors Motors------------------ HP....._._.......... Phase--....._...........
Motors........ ........... HP-------------------- Phase......------------ Permit Fee $1.00
Motors-------------------- HP� ------------------- Phase-------------------- H P Charge----------- -----�;�
-.TOTAL*FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring.......i--------- ---------------------------- Fixtures ------ ---------- ----------------------------
DATE INSPECTOR DATE El TOR
"Into .... ...... .
Finish'Wiring .----------------
.D A ------------------------- E
TE INSPECTOR Final
DATE INSPECTOR