2640LOS NO. �
R ELECTRICAL PERMIT
19 19641 14! CUPERTINO
Date, �d G �rT'+Ir9j'� Permit No.
Fce $
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 Premi=P=����+��/
Owner
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in
g Phone:
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NEW RPL FEES
Size Service Conduit.. _ ................Number of Outlets ....... ...-------- -Z% -------
Size
Size Service Wires ----------------- .........Number -of Sivitches---------------- --- --------
Size Service Switch ........................Number of Receptacles............ .........
�a
Size Sub Feed Conduit ------------------ Number of Fixtures_................�.------------- - --- d
Size Sub Feed Wires --------- ........... Ranges ....... ...... KW -------------- -----/-- --------- ........
Number of Circuits---'----"--" .. Oven ----1 ..... KW -------------- -- l--- --------- - - ---- -/
Number of Meters ------------------------ Signs .......... Transformers -------- ----------
Misc-------------- ...........---'-----------.... Dryers ---------------- /--------------------- ---/---- --------- --------
Motors ------- .-..... HP _------------------ Phase -------------------- Permit Fee $1.00
Motors ------------------- HP ------------------ Phase ----------------- .1
Motors ------------------ HP ------------------- Phase .................... H P Charge ----------....
/ TOTAL FEES I/1�d
QO OF INSPECTION APPROVALS
Rough Wirin _�...� I S.L------------- Fixtures ..........--- .-L.._._
r-
.-..01. E SECT TE/ SRECTOR
Finish Wirin .. .... Motors ................. .�>
I ........:....'-----------
ORTE IRRT[CTOt -.?s -- q.�fE.... L.. x�
Final ..._.. /.0 -----------
INSPECTOR E INSPECTOR