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2584NO. LOT NO. D �. V ELECTRICAL PERMIT CI CUPL•RTICdO JAN 31 7964 Date - 2 , iLL Permit No.62 57�p TY OF CUPERTI 11ri Fee S/ 75— 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 Owner By - SCONTRACTOR, AGENT Phone: �✓ r� �O��.S � State License Address /ey34R �oo- Address A pprove ELECTRICAL @R►ECrOR �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 .................. Size Sub Feed Wires .................... Ranges KW .............. Number of Circuits ------------------- Oven ----- ........ KW .............. Number of Meters Sig ns Transformers ........................ ...... Misc------------------------------------------------ Dryers_ ------ ----------------- --- --..--- I---------- (--------- ----- Motors ----------------- HP .................... Phase ---------------- Motors ------_---.--.-- HP ----------------__ Phase ------------..... Permit Fee $1.00 Motors ------------- HP ------------------ Phase ----------------- H P Charge ---------------- I --------- ...-- TOTAL FEES Rough Wiring -- -------- - -- DAT Finish Wiring ---------------- DATE V OF INSPECTION APPROVALS -- Fixtures--------------- 17KETOR .ATE ................ Motors .......... ......-.. IXSI[CTOX DAT[ ; Final ..................... DAT[ -----------.._..-- INSPECTOR -------------------- INSPECTOR ------............. INSPECTOR