35 - SIGN & ELEC PERMITLOT NO.
NO. STREET
W z c APPLICATJON FOR BUILDING PERMIT
r o ® TY OF CUPERTINO
o Sanitary N
W APR 16 1963 t N
P 5 Dat 196_ io.
�
LL W Ica is r4t;__itt mito
° a Cid ���
z N a story, yBuilding
<W
W
to be occupied only as
0 o in accordance with Plans, Specific ogg'and Plot -Flan filed herewith.
F3 Estimated Value of Improvements, $ Fee $
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* z all other law applicable to the construction, lo c tion, and use of buildings within the City of
o Cupertino w' comp ' th.
3�
W z ��� - Ale � �i(/� ss
� a BY
of
< u Phone Adak
Approved
State License � �� �� ��-. BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE
INSPECTOR
FINAL BLDG.
DATE
INSPECTOR
FINAL ELEC.
DATE
INSPECTOR
FINAL PLBG.
DATE
INSPECTOR
FINAL GAS
DATE.
INSPECTOR
NO. . STREET '
LOT NO.
ELECTRICAL PERMIT
�UPERTINO
Date (� , 195— Permit No.
I CU RT11" Fee S'i,..s�?
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 Premises S PA 2 k L
Address,;,
Address -t n C v N
Approved S
ICAL INSPECTOR
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 ---------- �- --- --
----------
--A�
Number of Meters ------------------------
Signs --- /___ Transformers --- _.___+_
___-__-_-
Misc----------------•-•-•-•-------------------------Dryers-•--••----------------------------•-•-•-I-----•-•--
----------
--------------
Motors .................... HP --------------------
Phase -------------------- Permit Fee
$1.00
Motors .................... HP --------------------
Phase --------------------
Motors .................... HP --------------------
Phase ----------- -------- H P Charge ----------------
..........
I--
6
TOTAL FE
St
RECORD OF INSPECTION APPROVALS
Rough Wiring ---------------• -•------------------•-------
Fixtures ---------------------- ----------------
-----------
DATE
INSPECTOR DATE
INSPECTOR
FinishWiring ----•----------- ........................
Motors ---•--------- --------• •--•------------------------
DATE
INSPECTOR DATE
INSPECTOR
FinaI------------------------- d------..----•----•----------
DATE
INSPECTOR