2697 N STREET LOT NO.
N Q Q'41964
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r o ® Ac FZ��fClD R ELECTRICAL PERMIT
3 < '� 'APR 2 4 1964 . OF LUPI RTIfdO
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0 Dat T ^, 195— Permit No.
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Fee 5 ��f��
a Application is hereby made to the City of Cupertino for a permit t�nstall electrical
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w a wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
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a wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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> City of Cupertino, and all other lags applicable thereto.
z J Use of Premises /2m ✓Br e e e, _
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3 < Owner o Address
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q G,�CpO-NTRACTOR, AGENT APPfOVe
Q V Phone: / O �OS3 7 dELECTRICAL INSPECTOR
q Siate License: a�S�7�
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NEW RPL FEES
Size Service Conduit---- ----------------.Num e-r of—Out Iets. -------------... .._------ ---- . ......... ....
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--.---- ------- ------. .------------
Misc.---....----------------------------------Dryers----------..-.....---..._-------- ------ - ------.. .--.---- -----
Motors-----_.---------- HP.................... Phase-----..-..--------- Permit Fee $1.00
Motors--"n- --------' HP................. Phase.------...-....---
Motor ---- -------------- HP .. Phase-.. ...... -.. H P Charge .... - ..
TOTAL FEES �
N RECORD OF INSPECTION APPROVALS
Rough Wiring.------------ -------------- ............. Fixtures ........ ------- -----I............................
DATE INSPECTOR DATE INSPECTOR
Finish Wiring . . ........................ Motors i
.... .. ..
DAT[ INSPECTOR
11 J �O�}L 1 ST[CTOII
Final .(.../�--.-1 --------------------
DAT[ INSt(CTOII