583 l bCoO l
NO. -----i Lor NO.
APPLICATION FOR ELECTRICAL PERMIT
f�f fq C OF CUPERTINO
Da �/`^""^' 2� l�uO 1 //->^^ Permit No.
96 L'
Fee
��Ql�ation,is hereby" FN0c City of Cupertino for a permit to install electrical
wiring and%or fixttures aass rsted 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 G OA"4w &1 4
c
Owner — Address ;A 0 �O
.i B'y Address
'� ^ CONTRACIOA, AGEM
L� t� Approved
!-
Phone: /�'�/ L Crov CAL KNOECrOl
NEW . RPL . FEES
Size Service Conduit---------------------- umber o6 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........----- ---------- ---------- --------.....-
Num f Meters---- ns---..-.-.- Transformers-------- ---------- ---------- --------------
Misc--- z. ---------- ryers...---------------------------------- --------- -------- -------------
Motors-------------------- HP-------------------- Phase-------------------- Permit Fee $1.00
Motors.................... HP-------------------- Phase-.------------------
Motors.................... HP--------- --------- Phase-------------------- H P Charge.-------------- --------
TOTAL FEES
i
RECORD OF INSPECTION APPROVALS
RoughWiring................ --------------------------- Fixtures --------------------:-I-----------------------
DATE INSPECTORjjjjjk_ DAT[ INSPECTOR
Finish Wiring -' - " ' Final�i���'T .....
v DAT[ INSPECTOR T INS(KlOR
{ . � � ,
• INSP[CTDR