2838 NO. STREU
LOT NO.
E �C ILIO
AOR ELECTRICAL PERMIT
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AUG 10 1964OF CUPERTINO ,
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o Days • —/d tT-'f�, 199 Permit No. �e
oa 11 Fee S
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
4 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the .
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. 5 0 City of Cupertino, and all other laws applicable thereto.
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Use of Premises
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3 a Owner AddresAELECMCAL
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Siate License 3 d
NEW EEL FEES
.... ...
Size Service Conduit ..----------Number of Outlets./2
Size Service Wires.... ............Number of Switches......... .....--- -- ---- -- -- ---
..... .....
Size Service Switch5;�0-0---—-----Number of Receptacles.,/-.;3-. ------ ------ . . . .....
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Size Sub Feed Conduit................."Number of Fixtures—'.14-4—F.------ ---------- --------
Size Sub Feed Wires--------------------Ranges................ KW....---.---- -------- -------- ---- --------
Number of Circuits------------------- Oven ........:... KW---.-------- ---------- ---------- --------------
Number of eters.----------._-------Signs....._... Transformers-------- ---------- ------- - --------------
Mi-Z� of
---------- --- Dryers. ..... - ------ ------ -- - --- -- ----
P �� Phase......------....J
Motors---..._...."----- H ....
Motors-------/... ..... HP ------------ Phase 74. . .... Permit Fee $1.00
Motors-------------------- HP-------------------- Phase..---......_...__ H P Charge ..... ------
TOTAL FEES
RECORDOF INSPECTION APPROVALS
Rough Wiring---------------- ---------------------------- Fixtures ......................
DATE INSPECTOR DATA
Finish Wiring ---------------- -------- -------------- Motors --------- .....
DATE INSPECTOR
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Final ------