2494 / o eo
NO. STREYJ LOT NO. .
P-PLLIC TION EOR ELECTRICAL PERMIT
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FloV 2 9 1963 ;OF CUPERTINO
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Date ��— b-�—•^•^1�� Permit No.
L;Ily Ur
`" Fee S r
a Application is hereby made to the City of Cupertino for a permit to instal 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 Cade of the
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m City of Cupertino, and A other lal�licable thereto.
o J Use of Premises
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3 a Owner l�ti�, d�minlM Address _
a yBy .�,Gs,i f tir Address
< O COpN�TRA,CTTOR, AGENT App roved '
�n7 ELEC[RrCAL INS►EC[OR
X State License; ?�lr� `�'
NEW RPL FEES
Size Service Conduit----- y(.........Number of Outlets----------- a.. ......... .....;?..)0
.... ....
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Size Service Wires........:�i-----------Number of Switches.._....-_----- --I-------- ------- . ..............
Size Service Switch...../ -piA;(-Number of Receptacles___...... -55j-- -------- 3-..-7.0
Size Sub Feed Conduit...--------Number of Fixtures....-- --------- ---;2 Q- ---------
Size Sub Feed Wires... yam------Ranges......I. -....--- KW.--.-------- --------- --------- ---------7...5-
Number of Circuits.........(.-----.
Oven ....J........ KW.---..._...- ---------- ---- ----- ------
NZr of M rt . .......Signs......._. Transformers--------I---------- ---- -----
i is!!
sc-- --------------------------------------------Dryers----------0-". ...... .. ...
c._;......... - ------- --- -- ---------- ---------- ...........
Motors--...... ....... HP----=--------- Phase,--------- - Permit Fee $1.00
Motors-------------------- HP-------------------- Phase--------------------
Motors-------------------- HP.................... Phase-------------------- H P Charge..--...........TOTAL
CO)M OF INSPECTION APPROVALS
Rough Wirin A lx�.. - --------- Fixtures ---------------------I-- --- -
0K Ims"CT.R DATI ..T.R--
Finish Wiring ................I-----------------OR---D AT I I K IP 9 C T qMotors ...... RAT,(....... --- I-R-SP.I.C-T-0-R.......
Final CD�-7t....... . --------------------
DATZ IkIPICTOR