2389 NO. STREET LOT NO. _S!
f�
rSefiEUS
ELECTRICAL PERMIT
P 19 IT CUPERTINO
Date ] ' Permit No. Fee
C L� l e e S //✓ -
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 aws applicable thereto.
Use of Premises
Owner Address ���✓'�s�Jn� s
By Address �/•
ONTRACTOR, AGENT
Approved
Phone: ELECTRICAL INS►ECTOX
NEW RPL FEES
Size Service Conduit..._-----------------Number of Outlets.....
' O
Size Service Wires..........................Number of Switches.....---------- .-.qq-L.....---I--- .--.-�--
Size Service Switch........................Number of Receptacles------------ .._.1.. ---------- . -----
Size Sub Feed Conduit----- ------------Number of Fixtures...__........... /�--- ---------- ---
Size Sub Feed Wires--------------------Ranges---------------- KW---------- - --- -------- -------
Number of Circuits-'-----'----------- Oven ------------- KW------------ -------- -------- --- ----------
Number of Meters........................Signs.......... Transformers...----- ---------- --------- ------------ -
Mise----------..-- -----------1- --....Dryers............. . ----- ---- --------------- ---
Motors-.-... -. HP ........� ..
Motors----- ....._...... HP.------------.---- Phase-..--..-../........ Permit Fee $1.00
Co
Motors-------------------- HP.------:------------ Phase-------------------- H P Charge----.....-...
TOTAL FEES
INSPECTION APPROVALS
Rough Wiring/
"�. �-
---- ----------------- Fixtures ---------------- ------------.._--------
OAT[ INSPECTOR DATE INSPECTOR
Finish Wiring ----------- --�-----...----------....It
.......--.. *--------- ----------------------------
DATE INSPECTOR DATE INSPECTOR
Final -------------------------- ............................
DATE INSPECTOR