2651R %/�+
NO. Q�EL LOT NO. �
PP LICAT IBR ELECTRICAL PERMIT
AR 19 1964CIF CUPERTINO
Date ��'%6 e' Permit No.
Fee 5
Application is hereby made to the City of Cupertino for a permit fo all 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 Premi=Pg-1`l�y/
c ,
Owne AddresO;2 0 /n/-u'O - �
By Address
CONTRACTOR, AGENT
Aoproved
Phone: ELECTRICAL INSPEC7D1
- .
NEW
RPL FEES
Size Service Conduit ----------------------Number
of Outlets... ------ .--------
—J,--
--..-.---- - Z9D
Size Service Wires --------------------------
of Switches ----------------
--- oL-
..--.-.--.I a2O
0.
�J
Size Service Switch _-.-----.--_----------Number
of Receptacles ------------
- -
_..-.....I
Size Sub Feed Conduit ------------------
Number of Fixtures------------------
1.! .-
- - .
Size Sub Feed Wires --------------------
Ranges ...... ...... KW --------------
--- /...
..........
Number of Circuits ...................
Oven ---- l...... KW..--.------
--Z---
---------- ------.N
Number of Meters.......................Signs..........
Transformers-------
---------
---------- -------------
Mise------------- - ---------------------
Dryers.. ------- /---- --- -------- --------
---/---
--------- ----- �
Motors ......
-------------------- Phase.. --
.----....-----
Permit
Fee $1.00
Motors.... HP
---_--------------- Phase -------------
Motors ------------------- HP
---_----------- Phase -------------------- H P Charge.....
--------
TOTAL FEES
3 RECORD OF INSPECTION APPROVALS
7
.
Rough Wirin--'-------...�.._.�..-._�~-----~---------
Fixtures ----------------�-
---/------
TE
iring ...............
Finish Wiring/.-
t INSPECTOR / OATE
... - - --- Motors...--..--------...
INS,
...----
DATE
INSPECTOR
Final
IN[t[CTOR
----- ---�/---- --
DA
'"--II---"�–~~.'----
INSRCTOR