2573 NO. STREET 01
LOT NO.
® AN 27996Tc
R ELECTRICAL PERMIT
F CUPERTINO
J _
Date Y 1� Permit No. S 7
CITY OF CUPERTINO Fee 5 g- G0
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 fixtur in accordance with the visions of the E rical Code of the
City of Cupertino, and all other laws appli ble thereto
JUse of Premi—
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V
.4 Owner Address ..�
By Gi Address F,
CONTRACTOR, AGENT -
� o �1 Approved
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Phone:'=�L L-/'O 0 U ELECTRICAL rNLTECTOR
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NEW RPL FEES
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Size Service Conduit-------------------...Number of Outlets-----------.------ --3..... ......
_.��_9�:.4
I
Size Service Wires-------------------------- of Switches--------------- ---.--- --------.I---
--.-..-
Size Service Switch------------------------Number of Receptacles..---------- ..-------- ---------- --------------
Size Sub Feed Conduit------------------Number of Fixtures........-------_- --------- ..............
Size Sub Feed Wires--------------- ..Ranges-- ' ....... KW.......... .. _.... . ....... ----
Number of Circuits............------ Oven -------------- KW----------- -------- ---------- --------------
Number of Meters.......-----------------Signs..7l Transformers........ .......... ......... d..p.
Misc---------------------------------------------Dryers....-------------------------------- --------- --------- ------------
Motors-------------------- HP-------------------- Phase Permit Fee $1.00
Motors-------------------- HP------------------ Phase-----
Motors.................... HP------------------ Phase-------------- H P Charge---------------
I------- ----
TOTAL FEES `✓' U
RECORD OF INSPECTION APPROVALS
Rough Wiring................ ---------------------------- Fixtures ..... -- ----- - ---
DAT[ IRSR[CTO[ DAT[ INSR[CTOR
Finish Wiring ......D-A--r[----- -------- -In[r[croR---- otors ---- - - - �- --------------------
war // TDR
Final -� .52.1- _Y�...
DA [ IFS[[CTOR