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242810 NO. STREET LOT IfO.• �O� OR ELECTRICAL PERMIT- OF CUPERTINO 11, OCT 2� 1963 b Date , 1 qr� = Permit No. 622 dCITY OF CUMT Fee 3.0 Application is hereby 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 Premises L?" gy��•�-�.E.� ��a_.e CVTRACTOR,4� Phone: 5`2- 3 Y 1141, �ddress "e Address 1 Approved NL ELECTRICAL INSPECTOR NEW RPL FEES Size Service C'�onduit--------- _------------ 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................ K •-----/.... ..•----------- ------------------------ Number of Circuits------------------- Oven ------•--•---- KW -------------- -------------- --------- --- Number of Meters ........................ Signs ---------- Transformers.....___ ------ Misc------------------------------------------------- Dryers --------•--•------------------•---•------------------------------------- Motors .................... HP -------------------- Phase .................... Permit Fee $1.00 Motors--------••---------- HP ---------------••--- Phase ....... ------------ Motorase-------------------- H P Charge ---------------- -------------- ./i2. C TOTAL FEES i RECORD OF INSPECTION APPROVALS RoughWiring ------•----•--•- --------•------------------- Fixtures -----------------••--- ------- ---- DATE INSPECTOR DATE INSPECTOR Finish Wiring---•---------------------------••-_-----Motors---------------------- ------ DATE INSPECTOR DATA / you 14'R 'f DATE INSPECTOR