2747 NO. RE L07 NO.
PUOICTAI TICN R ELECTRICAL PERMIT
AY 181964 c t F CUPERTINO
Date i , 195='f Permit No.
7-0 Fee ti a. U Q
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.
Use of.Premi<Ag
;.a Own �� Address
r�
Byy = Address f
CONTRACTOR, AGENT
Approve
Phone: LECTRICAL IMPECrDi
J
NEW RPL FEES
Size Service Conduit.._..................Number of Outlets_--------------- ---------- .........
L......__.-.
Size Service Wires.........._..........._Number of Switches_. ............ ... -- ----------
Size Service Switch........................Number of Receptacles------------ --------- ---------- -fr-OU
Size
Sub Feed Conduit..................Number of Fixtures------------------ ---------- ---------- ------.-------
SizeSub Feed Wires.------...........Ranges................ KW-------------- --------- ---------- ---------
Number of Circuits-------------_--- Oven .......... KW-------------- -------- ------- ---------..:..
Number of Meters........................Signs.......... Transformers........ ---------- --------- ------------'
Misc-----------------------------------------------Dryers..... --- ---------- -------- -------------
Motors.................... HP Phase.................... Permit Fee $1.00
Motors-------------------- HP-------------------- Phase............------
Motors-------------------- HP-------------------- Phase.................... H P Charge.----------- --- - --
TOTAL FEES U�
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- .--_--------------------- Fixtures ...................... ------------... -------- -
DATE INSPECT ON
DATE ECT"
Finish Wiring ................ . Motors ------'---- ... -�... ...................--
DATE INSPECTOR TE - SPECTOR
Final�..O.. .t. .... .. -------
DATE INSPECT"