2386 NO. STREET LOT NO.
64,3
P41041a R ELECTRICAL PERMIT
SEF I F CUPERTINO
JG �I G
Date Permit No.
CIT pee
Application is hereby made to the City of Cupertino for a permit t 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 Premis'< o
a OwnerAddress _7x
By / Address
ONTRACTOR, AGENT
_ Approved
f1�/ Phone: —� ELECTR[UL MfPRCI01
_ NEW RPL FEES
Size Service Conduit----------------------Number of Outlets------------------ -ad--- __--...
._. .
1 .....
�a
Size Service Wires-------------------------Number of Switches----------------- 17-- ...._....L.. ._/_�O
Size Service Switch------------------------Number of Receptacles............ . !a._ ___._ .yf'------
Size Sub Feed Conduit-----------------Number of Fixtures.._......_...... 1�`.. ._------_ ..../-��...
/ H/
Size Sub Feed Wires-------------------Ranges..._-J..---- KW------------- -/--- ---------- ---------
Number of Circuits------ ----------- Oven -------------- KW------------- -------- ------- -------------
Number of Meters........................Signs---------- Transformers........ _ ._ -.......-_ ._.....��
Misc-------------------------------------7 - -
�- _Dryers
Motors....... kPh-e
Motors.........
q--------. HP. Phase
---------------------
........-------Permit Fee--F-e--e- .$.._1...0.-0-
--�OD
Motors------------------ HP------------------ Phase........--------- H P Charge---------------- --- ------
TOTAL FEES /f
RFiGO OF INSPECTION APPROVALS
Rough Wiring, - ......... Fixtures ------------------- ---------------------- ----
DATE INSPECTOR DATE INSPECTOR
FinishWiring ---------------- ----------------------- Motors ....._...... --------- ------"'-----------------
PATE INSPECTORT�71 DATE INSPECTOR
Final ------- ------- ......'--------
OAT[ IMSP[CTOR