2523 ELECQ. STR r./ LOT NO.
� a a _ 1I
Y O
ir i�E(C�s-T R ELECTRICAL PERMIT
LL
o � JrF CUPERTINO
W LL J
LL o Date 1,95— Permit No. c�
o LO
< CITY OF
Fee SJ,Q p
aW Application is hereby made to the City of Cupertino for a permit to install electrical
F wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino,f and all other laws applicable thereto.
z Use of Premises �1���
3 � caner `�trv— !►Address ��'?T� S'S"
a
ui a Aly _ Address �O + ST *Jose
CONTRACTOR, AGENT
a a _ A ppro, —
— V Phone: C Z g � — � ELECTRICAL INSPECTM
(State License- 2 3 3 3� 3 3 __
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 ..................
..........
.........
..............
SizeSub Feed Wires .................... ................ KW --------------
----------
----------
--------------
Number of Circuits -------------------
Oven .............. KW ..............
----------
..........
..............
Number of Meters........................Signs.......... Transformers. .......
..........
_.........
..............
Misc------------------------------------------------
Dryers ........................................
..........
----------
..............
Motors -------------------- HP --•--------------
Phase ........-----------Permit
Fee $1.00
Motors ___. ......... HP ----------
Moto HP ----- ---------
hase.................... H P Charge ----------------
I -------.------
TOTAL FEES
i 3,00
17 RECORD
OF INSPE ION APPROVALS
RoughWiring --------- ...........................
...... Fixtures --- .................. ---------------
------
DATE INSPECTOR DATE
NSPECTOR
Finish Wiring ......... --
-- ----- .. Motors
DATE INSPECTORD E
f T:
OR
Final !R-- .......
---------------
DATE -
INSPECTOR