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2765®4 -��j NO. STREET LOT NO. APAzJn FOR ELECTRICAL PERMIT 0 2 I OF CUPGRTIfdO Date {l f MAY 2 2 1964 1. 195— Permit No.S Fee y/1. S 30 AGhTVior0FheGWKRTo, tAe 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 Premises Owner Gc By HEATH ELECTRIC L05TUTUW,GR 4?URNIA Phone: State Address Address Approved —_ ELECIIICAL INS►ECTUM Phone ELSato 6.4423 RPL Size Service Conduita/. ...._Number of Outlets........... Size Service Wires./„ la-------- ---- Number of Switches......... Size Service Switch.�-1���.r--Number of Receptacles..... Size Sub Feed Conduit ------------------Number of Fixtures_.............._ !C�,. .......... .... �..CT. Size Sub Feed Wires---...............Ranges.------1--- KW -------------- ---------- ---------- -------------- Number of Circuits-..-------------- Oven ....... ..... KW----------- ----_........... OG --5-- Nu be of M s.....1................Si ns...... .. ,� i� s /9 /,Yr PS t Transformers.............................. X,96 Mi....�...-._---- "..._... ....---D -------------------------- ------- ---------- -----"-� Motors ------ H Motors - -.. Phase -------------------- Phase Permit Fee $1.00 ---------------- --HP -------------------- Motors -------------------- HP -----'--------- ---.-.--- Phase --------- ------ ------- --- H P Charee---------------- I.l. d.- Rough Wiring Finish Wiring TOTAL FEES_ OF INSPECTION APPROVALS � Fixtures INSPECTOR DATE INSPECTOR DATE -T 01 37 N TOR .....----------- 1 CTOR ... .. . INSPECTOR