1377 NO. STREET `LOT NO'
PL 11 AAR ELECTRICAL PERMIT
D �''7tt.•.•�� p CUPERTINO J
Date f 1� 62 , 19 Permit No. `�7
TT��[ ��(�[[ ((++''ll C[pp�m� ^^II Fee S �3
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Appli�GJT is t1(1�by1pltlPI-eflh'rINP,f Cupertino for a permit to install electrical
4� 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
v Use of Premi«< -» e-
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a Owner / .Ea,4_,i�� Address
jg By 1VZ1 UApprove
ress
CONTRACTOR, AGENT
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Phone: �-�L" 'L C �� ELE GL INSPECT01
NET HPL FEES
Size Service 6onduit------------------------Number of Outlets...........1------ --/-,F-- ---------
Size Service Wires--------------------------Number of Switches.........------- --I--?-- --------- ---
Size Service Switch........._.............Number of Receptacles_.....----- -3.3-- -------- ----
Size Sub Feed Conduit------------------Number of Fixtures------------------ ---�--Z.. ......... ..... ---F'o
Size Sub Feed Wires--------------------Ranges....../........ KW.....--------- ---------- ---------- ---------
7 5
Number of Circuits--........._..... Oven ..x....- KW.------------ ---------- ---------- ---
Number of Meters........................Signs.......... Transformers------- ---------- -------- - —,------
Misc-----------------------------------------------Dryers ./---------------------------------. --
1-- ------ ---------- --------7-5—
Motors.---I--------.... HP-------------------- Phase........... ........ Permit Fee $1.00
Motors-------------------- HP-------------------- Phase-----------------
Motors
------------ - -Motors-------------------- HP-------------------- Phase-------------------- H P Charge---......------ I - /U O
TOTAL
harge----------------
TOTAL FEES
INSPECIION APPROVALS
. . ...... - ------- --------------
Rough Wiring,�Ozy Fixtures ----------------------
I------------ ---------
DATE INSRCCTOR DATE INSPECTOR
Finish Wiring ................I-----------------------
DATE IN219CTOR
-7 -C,