1299 (2) ao �
'4 NO.�` STREET LOT NO.
i ELECTRICAL PERMIT
rCUPERTINO qp
Date �7� Permit No.
,{ p (�
Fee $
ApplicaAVY; heffy y0 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;app�lic,�athereto. `
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u Use of Prem, J
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CBy wner Address /kYl
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4 ELOCTRIUL INSPECTOR
NEW RPL } FEES
Size Service Conduit......................Number of Outlets.................. ...Z ..050
.. ..._....: .,.
Size Service Wires.........................Number of Switches................ ..0.._.._ .......... .... .
Size Service Switch........................Number of Receptacles............ I.Q_.. ........_. ..L.QD
Size Sub Feed Conduit..................Number of Fixtures.................. ..7..... .......... ...L7P
Size Sub Feed Wires..._...............Ranges................ KW.............. .......... ......... ..............
Number of Circuits--------------.. Oven .............. KW.............. .......... --...... ...............
Number of Meters........................Signs.......... Transformers........ .......:.. .......... ..............
Mist................................................Dryers........................................ .......... .......... ...........
'...
Motors.................... HP.................... Phase....................
Motors.................... HP....... ............ Phase.................... Permit Fee $1.00
Motors.................... HP.................... Phase_................. H P Charge................ ..............
TOTAL FEES' I
_ CO F INSPECTION APPROVALS
Rough Wiring,. ? A LJ ._.... ............. Fixtures ......................L..::......,................
01TL / --..IMIPLLTOR � ....-- UAT[ � INSPECTOR �
Finish Wiring ....:........ . . ......... Motors . I....
- --- -- ------
OAT[ INSPECTOR ------
`
OAT[ INSPtGTON
the undersigned do hereby certify that I am
the owner and oce pant of the single family dwelling at k 4
Q� _Cafor which I ar. making
application "to do work, a= a hom c.,mer,
I also certifythatt _ csi11 noc Y..;'e any non .iice::.sec '
_ger contractor, but'.i+i1], do this work myself,
TELEPHONE 'NI^2'3t E[2
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