2644M
a
NO. STREET LOT NO.
R ELECTRICAL PERMIT
CI � CUPERTINO
181964
Dat 1 Permit No.
CITY OF VUPIRUfo Fee� /a CFO
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 PremiS&q
owne��- Address 17
By
CONTRACTOR, AGENT Approved ���� '/
NEW
Size Service Conduit......................Number of Outlets.
Size Service Wires-------------------------- Nuniber 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 ........
.__......_._................:`.
Misc.------------- --Dryers ............... --... ,------------
...J.---
Motors ------ ,.�...---- HP -------------------- Phase ----------------- Permit Fee $1.00
Motors------------------- HP ------------------- Phase -----------------
Motors HP ----------t------- Phase -------------------- H P Charge ---------------- �O
I e I TOTAL FEES �-
Dt O OF INSPECTION APPROVALS
Rough Wiring l... C( -a.4-- Fixtures ----- -....-------� ------...-------
g DAT I! INSPECTOR_ DAT[ .- MSS[CTOR
Finish Wiring ..................................... Motors --- --- . ..-------"...—..
OAT[ INSPECTOR i �pA_T -------------------
INSPECTOR
Final............L.......-- �............_.......... '--
DAT[ INSR[CTOR