2287 / QG SSI E-. DPjur= � LAUIjbk ' MNi�
NO. STREET /,� _,1 y� LOT NO.
CMAgrt+l2 SNoPP/"'C> krT
APPLICATION FOR, ELECTRICAL PERMIT
J&Ex
CITY OF CUPERTINO
Da
AUG,(A -;GJ •�� 194�). Permit No. c2,cP-f
3 W Fee 5 11 OO
n Application is hereby made to the City of Cupertino for a permit to install electrical
wieffytd �fiv i !' I61r 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.
r
a Use of Premises (20 to E R C I!4 C (S25 eklt= C-E/i N
Owner M WUEL Cos4elIc, Address
v
By U - / c Elc 1C Addre
CONTRACTOR, AGENT
'26Approved
EPhone. NS1ECr01
• NEW RFL FEES
Size Service Conduit......................Number of 0utlets.......... :s _ ----------
Size
Size Service Wires-------------.............Number of Switches---------- - -- ---.----- ..........i._1/0
Size Service Switch........................Number of Receptacles....�� --------------
.. .......... ..........o� 0
Size Sub Feed Conduit..................Number of Fixtures---------C3--- ---------. ----------
Size Sub Feed Wires.................... anges---------------- KW------------ ------- -------- -------------
Number of Circuits................... Oven .............. KW----------- --------- -------- ------------
Number of Meters.......................Signs.......... Transform/ears........ ...
Misc------------------ - ---Dryers-------._1. --------1�'..,7SS�c=--- -------- .��...��.
Motors.......... .....-- HP-------- �------ Phase......I-- --------- - -
I
Motors-------------------- HP-------------------- Phase. Permit Fee $1.00
Motors. HP-------------------- Phase-------------- -- H P Charge_-------_----- ..at 00
TOT;AL�FFEES ��• 00
RECORD OF INSPECTION APALS
RoughWiring. - -.. Fixtures - - - -- -{'-
L.... '---- --------
/) JATC INSTFCTOC �/ q INSTCCTOC
Finish Wiring'7.'.-- -_.,.�.. ..QSu......... Motors ....-------. --- - --
_�. .._-'-----'------
DATE ( I.SP.CTOC ATC � l IXIX CCTOC
-s i
Final ----�--L�----........I-'------�----------------
DATE 1. INSr[CTOII