1607 (2) • NO. STREET LOT NO. � S
APPLICATION FOR ELECTRICAL PERMIT
CITY OF CUPERTINO
Date 195 Permit No.
!�_
Fee / 3 —
r s h` y; rto ity of Cupertino for a permit to install electrical
Appl ti�,�y�j ��. �'. .
wiring an,d/orjiztuies"•as:listed .o he'reverse side hereof, and agrees to install said
wiripg itld/oj�filxtu e' 46-a Ordadce xJith the provisions of the Electrical Code of the
City d� Chap htlno r�P[Q„11��1A�''6`t s applicable thereto.
Use of Premise°i �L
y� r
caner (i1i +� � Address
' I y :. ..-.. Address
CONTRACTOR AcsApproved
Phone: Qa ;P) n- �I - eLH IGL INHPHC101
NEW HPL PEES
Size Service Conduit.....................:Number of Outlets.................. ./....`1... ....:..... ...!.:4.0
Size Service Wires.........................Number of Switches................ ...� 2 i a
....... ........I. ..............
Size Service Switch........................Number of Receptacles............ A . .......... ....�.g_�
Size Sub Feed Conduit..................Number of Fixtures.................. ./..7.. .......... ....
/...�d
Size Sub Feed Wires—_...............Ranges.../........... KW.............. ..2. ... .......... ........7s.
Number of Circuits................... Oven ../......... KW.:........... ...7.5... .......... ......-ZS
Number of Meters........................Signs.......... Transformers.:::... ....:
.... ......... ...............
Misc..........
.....................................Dryers...l................................... ...
7 .. ...:..:... .:.....75
Motors.... ............ HP.................... Phase.........
.i......... . . Permit Fee $1.00
Motors.................... HP.................... Phase............:...... ,
Motors.................... HP............6....... Phase.....6........:.,.H P.Char&eyt_:.......:..;: .l Q.O...
TOTx1t.FEFS:;, 3 oS
RECORD OF INSPECTION'APPROV
Rough Wam ............I-- .............. Fixturest:::.:.:' ..... .....�.......:.:..............
OAT% [NSP ....
DAT[ IND[OTOE ': 4 D.1Y[�• 'rY INfr CCTOR
Finish Winn ................ ....:........ Moto
8rs'•:_.: ..:.
Den IX[riDTO[
nen �xer¢rDN
C� ELECTRIC SERVICE NOTICE OFFICE
y,
} BUILDING INSPECTOR'S- OFFICE COPY
CITY OF CUPERTINO `
oL 4
I
To
You are hereby auth d to connect the ELEC IC ser to -
Owner or Tenant ..... .. .. .. .. ........:... ..... .''..: . .
. ....,.,._. .........---....
ti.
At
1.61.3..'.... ::::,....... fv''...
---------------
No
. of Wires .:.... ..:........... Size of Wires.:..._� :.....::.;Stze'of Switth;CGrYL,�c.'..
Motor Load . -... Voltage - _ Ph _ '
g ase'.
.Y. • p .
Heating Load �...................... K. W. .................;. .......`..... -Voltage .. ..... ....................
Light 110 ` " New Service �—a Reconnect .......... ...
"No of Meters, .Heat 220 1�. Three.WireMove Service ..........
No of Add Meters r' °" + r
• Power .............. Th_. , ha ... :.,:._...hfove,Meter ............
Jyt •�• LECTBICAI yI1VSPECTOR
too 7/61-500 '�• r• ,