2391 NO. EG� LOT NO.
V
TIOFIR ELECTRICAL PERMIT
I 12 1963�:IF CUPERTINO
Date 1K1i01941 Permit No.
Fee $
Application is hereby made to the 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.
J Use of Premis— T_
Owner Address
By Address
CONTRACTOR, AGENT
/� Approved
Phone: ��—`` _//� �� ELECTRICAL INSPECT=
NEW RPL FEES
Size Service Conduit-------- -------------Number of Outlets_--- ----------- .f
Size Service Wires....-....._...._.......:Number of Switches__........... . ......L...._..-I- ........-_
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--.---. ----`----- ----------
------- - ---.../---�---. ------------J
-,.
Misc.------------- - Dryers --------- / -.------------- -- ` .....--- ....
Motors........ H )Z-- . --- Paze
Motors----------------- HP........-----.... Phase_------ Per[nit Fee $1.00
, .
Motors------------------ HP.................... Phase--- ---------- ---- H P Charge----------------I -----
TOTAL FEES
,R� OF INSPECTION APPROVALS
g
Rough Wiring I O'j 0- _. ... ...... Fixtures ..--------------.--- -
8 -------- -. .. ....---------------------
GATE INSPECTORDATE INSPECTOR
Finish Wiring ....:.-oATe-------I-- I----x 51 Ecr-- C--oR_.... Motors ......
....._oer[--------- N
Isr[cr0-------- -....---R......
�
Final .......................... _. ...._.......
OAT[ INSPECTOR