2695 /0'/y 1 LA' Rt/ vv/3 /
0 NO. 0 ST LOT NO,
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A PLICATIO OR ELECTRICAL PERMIT
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APR 22 1964 OF CUPERTINO
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d'�7�'�f�'' f I IP T;na�
Datv� , 19�� Permit No.
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<m 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
w wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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> City of Cupertino, (hand all other laws applicable thereto.
o J Use of Premises ' e S ( a 0 l�177 D IJ
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3 N Owner PN I L 1 Q KU S t9 Address
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CONTRACTOR, AGENT -
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< o _ , Approved
—V Phone: 2 S 2- 1 ELECTRICAL INSPECTOR
State License, 2 4 l 2 -
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_ NEW RPL FEES
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Size Service Conduit.-.-- •--_Number of Outlets------------------ ---3-.. ......---. ._-.'30..
Size Service Wires......._----Y........Number of Switches.._............ ._.!.
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1,80
Size Service Switch------/ �7.�j--Number of Receptacles............ ../...Y..--- --------_ ..-...-----...
Size Sub Feed Conduit------------------Number of Fixtures------------------ -.3---- -------- ---)•..........
Size Sub Feed Wires--------------------Ranges---------------- KW--------------
Number of Circuits----------------- Oven ------------- KW-------------- -------. ._._..-- --..---
..----
Number of Meters------------------------Signs.......... Transformers-....--- -...------ -. --
-_---.-----_
Misc----------------------------------------.Dryers.----------------------------------- -
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Motors-------------------- HP-------------------- Phase-------------....._
Motors.....------------------------ HP-------------------- Phase-------------- Permit 0
it [t'— /,Fee $1.00
Motors------------------- HP_.-................ Phase_. - -------------- H P Charge----------------
TOTAL FEES S /
O � OF INSPECTION APPROVALS
Rough Wiring---- -cid ' .....:.................... . Fixtures ----... _-.._---- �-
OATE INSPECTOR / OATE� IX51[CTOR
Finish Wiring --------------�---------------------- Motors ....- ------ -- �-
MTE INSPECTOR �1 �O✓r IXs1 CTOR
Final --- ------ .._'........ --- - - ------------
OATS INSPECTOR