ELECTRIC PERMITv
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NO. STREET LOT NO.
in OR ELECTRICAL PERMIT
FER 2 Q l96�CI OF CUPERTINO
Permit No. Q
CJ
Fee S 0
DateC!T Z — Z&_G , 195_.
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 Premis
Owner f��O
By
CONTRACTOR, AGENT
Phone: 2SZ - /00 U
Address
Address
Approved,— t.0
ELECTRICAL INSPECTOR
NEW RPL
Size Service Conduit ---------------------- Number of Outlets ------------------ ---------- ---------- I-_..___.__..__
Size Service Wires.........................Number of Switches------.--------- ---------- ---------- •_------------
Size Service Switch........................Number of Receptacles ............ .......... .......... ..............
Size Sub Feed Conduit ------------------ Number of Fixtures.. ................ .......... .......... ..............
Size Sub Feed Wires ... _............... Ranges KW .............. __________ ._......................
Number of Circuits------------------- Oven -------------- KW .............. •---•-•--------••--•..............
Numbe�qMeters .................. .Signs------_--- Transformers_........_......._ __......................
Misc.--------- .. Dryers------------------------------------------------------------ - .......
Motors .................... HP -------------------- Phase .................... Permit Fee $1.00
Motors.................... HP .................... Phase ....................
Motors .................... HP --•---•------------- Phase .................... H P Charge --_-----------I-------•------
TOTAL FEES 3 uU
RECORD OF INSPECTION APPROVALS
RoughWiring •------•-----•-- ............................ Fixtures ---------------------- -------•--------------------
DATE INSPECTOR DATE INSPECTOR
FinishWiring ----•--•-------- -----••-•----•--------_.Motors .............. .......... --------•-------------•----
DATE INSPECTOR DATE INSPECTOR
Final.......................... -------------•--------------
DATE INSPECTOR