2655re C
LOT NO. Lot 123 _
T FOR ELECTRICAL PERMIT
f -. FI OF CUPERTINO
U
o rr
w LL i MAR 20 1964 'p-
95— SS
=
4 w Date Pemlit No.
oy3.00
a Fce
a w ApFUTiY, iNPre1G14KRTjN0ty of Cupertino for a permit to install electrical
w = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
a wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
o 0
> City of Cupertino, and all other laws applicable thereto.
�3
z _jUse of Premises Use POWER POLE
J2
J O
3 <
Owner Ward CrUMID
- N
w z
w w
By —
h
o
CONTRACTOR, AGENT
i
-U
Phone: 253-0800
Site 253-3025
State License:
Address
Address pertino
Approved
ELECTRIUL INSTEC701
Size Service Conduit ----------------------
Nutsner o 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 --------
...._.-_
Mist-----.
Motors ..
Motors ..
Rough Wiring.........
DAT
Finish Wiring .........
DAT
FRPL IITFEES
------ ---------
HP........._..._....
Phase
HP
..............._._
Phase----.
Permit Fee $1.00
--------------------
HP ..-
--- Ph
....
H P Charge----....----
--- I�,O0
TOTAL FEES
RECORD OF INSPECTION APPROVALS
_..... --------------------------
Fixtures------------------�------_......----------
E
INSPECTOR
D TE
INSPECTOR
--------
Motors --`'-----
-
E
INSPECTOR
I------�-
t IST{
�f INSPECTOR•
Final .... ..---41-x------�I------
"_............
DATE
INSPECTOR