2650NO. J�21 LOT NO.
)FF�
CAT�Q[� ELECTRICAL PERMIT
CUPERTINO
Dat c,_ b a X19 Permit No. ;2 �O
Fee 5 � 00
to
Application is hereby made to the City of Cupertino for a permit 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.
v Use of Premise=p
7 Own Address -
By Address/
CONTRACTOR, AGENT
Approved
Phone: ELECTRICAL INSPECTOR
Size Service
of Outlets.__...
Size Service Wires ........ 707 ----.Number of Switches ----------------
Size Service Switch_/d0,/,24 ...... Number of Receptacles............
Size Sub Feed Conduit -------- . ..... Number of Fixtures-. ----------------
Size Sub Feed Wires....-.." ..Ranges......./-----. -------- ------- KW --------------
Number of Circuits....-------- Oven ----- ------ KW. -------....-
RPL FEES
Number of Meters -----------_-----------
Signs ----------
Transformers --------
Misc ---------------- --------
--------------
Dryers
Motors ----
��V -------
Phme
Permit Fee $1.00
Motors --------------_---- HP ....................
Phase --------------------
Motors-------------------- HP --------------------
Phase --------------------
H P Charge--------------- ------
iarge----------------
TOTAL FEES
TOTAL
Rough Wiring`77 .. z-1 --- q- I - ---- Fixtures ---------------------- -------- --
DAJ E
INSPECTOR
NSPECTOR
�--- ----- .........O. .R
Finish Wiring......------- -C---... Motors ..................
DATZ IKSPET0R2T ..
Final �_
DA -
.-.-.-.-.-.-.-
INSPECTOR