2835 L
STREET LOT NO. �.
DC7 O
?7
. AOR ELECTRICAL PER IT¢
l�ISEF 1 63CI�OF CUPERTINO
/ 2
Date _ I f1Permit No.
.. . Fee 5
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.
v Use of Prem;
c
;� Owner Address -
By Address ,
05 ONTRACTOR, AGENT
_ _/� Approved
(i Phone: tJ ELECTAIUL INSlEC7C1
NEW RPL FEES
Size Service Conduit......................Number of Outlets................-. 45-- ---------
Size Service Wires.........................Number of Swit chesA---.-:------- -/(5.... ....._..- _ ./......
I �9
Size
/(5 -- ---------
Size Service Switch-----------------------Number of Receptacles.........._ a9.. .........-
---------- -
Size Sub Feed Conduit------------------Number of Fixtures------------------ ?�---- ---------- ---
Size Sub Feed Wires-----------.....Ranges------/.---- KW.........---- ./---. '----------- ----- --------
Number of Circuits-'................ Oven -------------- KW............. ---------- --------- -------------
Number
--------------
Number of Meters------- ................Signs---------- Transformers........ ---------- ----------- ---------------
Misc----- ---------- Dryers----...------------/ ......
-----:74-��--/ ------ -- -- --- ---------- - ------
Motors.------!.7 L Phase-----------.---
-------------------- HP.................... Phase-------------------- Permit Fee $1.00
Motors-------------------- HP........._..__... Phase......---------- H1 P Charge—.-.51...... .../,60
I --------0
TOTAL FEES�—�,,
RC
% OF INSPECTION APPROVALS
....1�
Rough Wirin�i . ................. ----- Fixtures ............. ...... . ------------------ -- ------
DATE INSPECTOR DATE INSPECTOR
FinishWiring ................I---------------------- Motors ------------- ---------- ----------------------------
DAVE INSPECTORDATE INSPECTOR
Final ...........*D,AT,R......... --------IN-S,-I-C-T-0R- -------