2563 01075 5o. HiwAV
NO. STREET LOT NO.
P1ELECTRICAL PERMIT
CI CUPERTINO
1J_4
N 22 1964
Date j. .2: , 1 Permit No.
CITY OF CUPERTINO Fee 3, c
Application is hereby made to the City of Cupertino for a permit to install electrical
f wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
rn
.9 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
,z} City of Cupertino, and all other laws applicable thereto.
r_ /1
v Use of Premi=P= tq c-
c
V '7� �
;.a Owner FEESiDE 1NV�.SIMENi Address 10675 9
yBy Cu PE.2Tinio F EC'TelC Irc. Address 9
CONTRACTOR, AGENT
Approve
Phone: =?S—Z—/OOU LErnuuL INSPE i
L
NEW NPL FEES
Size Service Conduit----------------------Number.-of,Outlets.................. ._..np.
Size Service Wires-------------------------Number of Switches---------------- ---------- _.._I. ...-------
Size Service Switch........................Number of Receptacles------------ ---------- ---------- --- ------
Size Sub Feed Conduit-------------- ---Number of Fixtures.................. ...o.... _.-...... .�' ®10
Size Sub Feed Wires-----------------Ranges------------- KW........------ ---------- --------- --------------
Number
------ ---
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 3' d
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- ........ .......---......... Fixtures .....--------------�---- -----------------
o�TL ILs[[croL oerL ILarttroe
Finish Wiring ............ ---------------------.-.. Motors --- -- - -�..�.
DATE INSPECTOR
FinalDdTX
-- _`_ ..
O L IIIS[[CTOL..