2608-ELEC PERMIT-
NO. EET LOT NO.
CAVI OR ELECTRICAL PERMIT
`..
'SES 2 8 196�I . F CUPERTINO
Date - 1 1 T d T �I�T , 195— Permit No. "X
I ' 1 te
G
Fee $
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.
remiOUse of Premise-
Owner
wner
By
CONTRACTOR, AGENT
Phone: 2 S-2- -,,o00
Address &2- Zy 5 i5L'V1Vey
Addr
Approved
REc"Tiu�xt INSPEcrm
Size Service Conduit ----------------------Number
of Outlets.. -------------- --
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------........
NEW RPL FEES
----------
---------- --------------
---------- ------•--- I------------ -
----------------------------------
.......................•....•--•--
Numberof Circuits ------------------- Oven .............. KW -------------- ---------- ---------- --------------
Number o Meters ........................ Signs .......... Transformers....---- .......... .......... ..............
Misc.- ; .................v'� Dryers . O(�
Motors .................... HP -------------------- Phase -------------------
Motors -------------------- HP .................... Phase --------------------
Permit Fee $1.00
Motors.................... HP -------------------- Phase .................... H P Charge ................ I..------------
TOTAL FEES i� d O
RECORD OF INSPECTION APPROVALS
RoughWiring •----------•------------•------------------- Fixtures -----------------•---- •------------------------•--
DATE INSPECTOR DATE INSPECTOR
FinishWiring ---------•---•-• ------------------------ Motors ............. ----•----------------------•---------
DATE INSPECTOR DATE INSPECTOR
Final .. -- ---------
DAT[ INSP[GTOR