910 ELEC PERMITNO. EET ' •/J LOT NO.
%ELECTRICAL PERMIT
l DEC 7 19601 CUPERTINO
Date w— Permit No. 91 O
Fce
Ai 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.
v Use of Premises
c
OwnerEp
Address
a By Addr:ge--s
/2$hone:�C Apprve ELECTRI INSPECTOR
1
NEW RPL FEES
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 .............. .......... ----....................
Number of Circuits ................... Oven --•-••---••--- KW .............. .......... -----•--................
Number of Meters ........................ Signs .......... Transformers ........ .......... .......... ..............
Misc------------------------------------------------ Dryers ........................................ -------•-- •---------..............
Motors .................... HP -------------------- Phase .................... Permit Fee $1.00
Motors -------------------- HP .................... Phase ....................
Motors -------------------- HP •--•---------------- Phase .................... H P Charge ---------------- ------..------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring -------•-----•-- ............................ Fixtures --•-------------•----- --- --- --------- .........
DATE INSPECTOR DATE INS T R
Finish Wiring -----------------------------------------otors ............. .........
DATE INSPECTOR J E 1 1EC
Final � .. / 1 J(Lj� -- ....... ---
DATE INSPECTOR