2606' a a NCO / I✓ STREET LOT NO. ss
o WT40 F R. ELECTRICAL PERMIT
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Date —, � . �� -- —� 19�`� Permit No. ,� �
a 611 TUr C 111U J
Fee
a m Application is hereby made to the City of Cupertino for a permit to install electrical
r wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
j wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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m City of Cupertino, and all other lases applicable thereto.
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Use of Premises T m D -
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Owner 1.'0 Pb/T/fP t EV, rO. Address J-119 So W10 /1OA•.Si 40
w w By ���� _ Address
QO / CON ACTOR, AGENT Approved -
- u Phone: R x.915 9'G I ELECTRICAL INSPECT01
State License: 1�a
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NEW RPL FEES
Size Service Conduit ......................Number of Outlets............------ ---------- ---------- ------- ----
Size Service Wires -------------------------- Number 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 ------------------- ...------------------ -------- ---------- -------------
Motors.................... HP ------------- Phase --------------------
Motors----------------- HP .................... Phase ......__.---------
Permit Fee $1.00
Motors------------------- HP ............. .---- Phase -------- ----..----- HP Charge ................
I---------.--
TOTALFEES
RECORD OF INSPECTION APPROVALS
Rough Wiring ................ ... Fixtures ..................
DATE INSPECTOR OAT[ INSPECTOR
Finish Wiring......---------�------------------ Motors ....,-
DATE INSPECTOR i
Fin --- ------.--.-.-. -��.........................
...
..._.`R.y...E.C..T.O..R.
.....-.
DATE INSPECTOR