2796 NO. SIREEi LOT NO.
o @ I tNi R15LECTRICAL PERMIT
3 < DI JUN g 1964 c1: F CUPERTINO
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• LL o Date 1951-7 Permit No. zg 6
° CIT OF CUPERTi90 gee 5 J- 66
. 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
j .. wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
5 City of Cupertino, and all other lases applicable thereto.
z_j Use of/Prreeem
Owner �l,lL - � /�✓ � dr s
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W W IBy
aco R /T A rove
—u �/Phone: ELECI'AIUL INS►Er,7Gi
State License: 71-"12Z,
NEW RPL FEES
Size Service Conduit----------------------Number of.Outlets.................. . ........ ._------ ------- .---
Size Service Wires--------------------------Number of-Switches-------.------ --.----- ---------- ----------
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---------- Transformers........ .......... .
Motors------------------ HP---------..---- Phase-------------------- Permit Fee $.1.00
Motors.................... HP.................... Phase.........-..........
rs----------_..._./HP--. -..... - --- Ph _.. H P Charge...
/ TOTAL FEES
41 RECORD OF INSPECTION APPROVALS
Rough Wiring - - --- Fixtures .............._._ .
g g----------- ---�----.......---CT -- - - - ---'`----- ----------
OAT[ INSPECTOR OTE Ixs mroR
Finis/ h Wirin -------........ . . .-. Motors---- .-..-- .. -- ................
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01r[ INa1[croR /� • [ / / PIV Olt
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agL_ 13l 10 Final .-.. .1! -� ...1 .'...F� --
- INSPECTOR