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1026 (2) NO. STREET LOT NO. ATf AIPR 2 04 R ECTRICAL PERMIT 1 APR 2 0c1961 Fut ERT1N0 Date 1 . � Permit No. b 2' CIT OF CUP.ERTIIV0 Fee S l 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. Use of Premi �J {/'�/ C spq i�jy1( .ln.[Aiy KIX.�I 2 i' 4C a Owner _ Address 4� By. - Address r_ ;: .•. CONTRACTOR, AGENT - Approve hone:+ ELECTRICAL INSPECTDI '�� .f to y NEW RPL FEES Size Service Conduit......................Number of Outlets.................. .:........ ..... ------ ------ ' I Size Service Wires..........................Number of Switches---------------- ---------: ..-------- ----.._..._. Size Service Switch........................Number of Receptacles------------ ----7---- Size Sub Feed Conduit.................Number of Fixtures................. ---------- ---------- -------------- Size Sub Feed Wires---- ...............Ranges---------------- KW------------- ---------- - .............. Number of Circuits------------------- Oven ------------ KW------ ----- -------- ---------- --------""--- Number of Meters........................Signs---------- Transformers........ .......... .......... .............. Misc--------------------------------................Dryers---------------------------------------- ----------I-------- --------- Motors-----------------. HP-------------------- Phase------------------ Motors.................... HP..........--------. Phase------------------- Permit Fee $1.00 Motors-'-.._........... HP------------------- Phase------------------ H P Charge.------------L...."'--•-- TOTAL FEES 7D•. ' RECORD OF INSPECTION APPROVALS Rough Wiring........TF.... 'Futures ' OATS INSPECTOR '. + INSPECTOR . ... Finish Wiring --------- ----- ...... ....... Motors ----. ------- --- PATE . ` INSPECTOR:' F9 , IN lam?. ' DAT[ INSPECTOR.