941 STREET LOT NO.r
(2z � 6�.
APPI I&ATi
VI 'j'
ELECTRICAL PERMIT
7 CUPERTINO
DateJ Y 18 Permit No. � T
Fce
• G �
ApplicBjjiYs *y OUPERTINOf Cupertino for a permit to Install electrical
�p 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
M City of Cupertino, and all other laws applicable thereto.
v Use of Premises /'�
c
V
Owner -/Yi 7'c'o A/Siff Address
14 By Address
�hCONTRACTOR, AGENT TJ
zR'Z `�PProve
hone. • ELE ICAL INSPE(,rm
t��
NEW RPL FEES
Size Service Conduit._...1_._`f--------Number of Outlets--------
-✓__ __________ ----------
Size Service Wires.... ___________Number of Switches---------
�2�7---- ---------- ----------I------ cL
Size Service Switch-----ZP' ..._..__Number of Receptacles-----/_---- __________ __________ ------
Size Sub Feed Conduit..................Number of Fixtures----------- . .......... .......... ._ .�`�
Size Sub Feed Wires-------------------Ranges---------------- KW.............. .......... ---------- ....---.------
Number of Circuits................... Oven .............. KW-------------- ---------- ---------- --------------
Number of Meters........................Signs---------- Transformers--.----.I---------- ---------- --------------
Misc---------------------------------------
Dryers --- _ - ---------- ---------- ---------- --------------
Motors-----2------------ HP----J------------- Phase---`7. --
Motors-------------------- HP-------------------- Phase---- --------------- Permit Fee $1.00
Motors-------------------- HP----•--• ----------- Phase-------------------- H P Charge------ -------- -.4 2
TOTAL FEES i a
C( NSPECTION APPROVALS
Rough Wiring//7.....f l �.. --•----- Fixtures ----•----------------- ----------------------------
DATE INSPECTOR DATE SP O
Finish Wiring ................I -----------------------fFi
otors ------e
•--•--�----
--
DAT
DATE INSPECTORnal / ./. INSPECTOR