1778 (2) .. ./0272 (� -
- NO. LOT NO.FOR ELECTRICAL ELECTRICAL PERMIT
4i! '���� 2 Z 962 COF CUPERTINO
A Date +n��- AIA ror e°n194 z- Permit No. / 779
W� �vuCCbn A
Fee S a
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
M wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
\ City of Cupertino, and all other laws applicable thereto. -
lcv Use of Premises
Uh �\ t �• } ~�f}
K
Qwne Address
.�
Address 7
s
'J'T.�1-; -cmOR AGENT
' N�— r Approved
-Phone: X'6.820 E GTIIUt PE N
NEW "L FEE---
Size%Service Conduit...--- -Number of Outlets----------------- --------- ---------i------:-....-
l"
---------- -------------
T
Sizel§ervice Wires_----------_-----------Number Of Switches------------— -------- - ---------- ..............
Size Service Switch-----------------Number-------------------Number of Receptacles----.----- ---------- ---------- --------------
Size Sub,Feed Conduit---------------Number of Fixtures....(/ ...... --------- .......... ...q
SizeSub Feed Wires-----------------Ranges---------_---- KW-------------- ---------- ---------- -------*------
Number of Circuits------------... Oven -------------- KW------------- ---------- ._------Number of Meters...-----_---------Sighs-------- Transformers-_---- --------- ---------- ---------
Misc.... ..
... ........YR ----
--- - --
------- ----Dryers.-------_----------------------_--- ---------- ----------
Motorse ------....... Permit Fee $1.00
Motors...-.... e.!:
Phase..........`4---- WP
-Motors
�i-------- ...... Charge--------------- --- ..........
EES_�-- 4f
REGE. ....... M-WIINSPE P
RoughWiring..----------- --------------------------- --------- ..........
DATE INSP CTOR DATE X It"O.'e�,tj
Finish Wiring ----- ----VAT-E----- I-H-SP-C-I-a --- Motors ------ --- ---
AT
Final Z�_ -Sr-----
ArE 1.