2753 DNO Q 'REE LOT NO.
r o ,4PP C N �OR ELECTRICAL PERMIT
o D �A�� C - "OF CUPERTICIO
3u`
LL Date COW H ERTi- 9 �3
195— Permit No.
° a Fee S�5. 0o
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a Application is hereby made to the City of Cupertino for a permit to install electrical
w i wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
5 0 City of Cupertino, and all other laws applicable thereto.
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Use of Premises
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OwnerAddress
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w W By HEATH ELECTRIC _ Address —
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Approved
—U Phone-�4r�--� ELECTRICAL IMPECTm
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State License: z ���.
NEW RPL FEES
Size Service Conduit -------------------Number'of Outlets.._.....____. 4 - - ---- ----- - ---- -
Size Service Wir&�75ze------ ......Number' of Switches...._.____. .:�q. ......... -------------
Size Service Switch-.4:�V"9---Number'of Receptacles.__...... ..... - --------- ..............
Size Sub Feed Conduit---------------- Number of Fixtures........_...._..120- - ----- ----5?
ad
Size Sub Feed Wires--------------------Ranges......../...... KW...--.-.--.-- ---------- ---------- --------------
Number of Circuits------------------- Oven ..... /.... KW.----------- ---------- ----------
Number of Meters----/-----------------Signs.......... Transfgoryers .......... ---------
IC
C :7!r
Misr---------- --------- - --D S........ ----------------------- - - --------- ---------- --------------
.40r--- ----------- --- "ke I
Motors.... .............. HV�- - --- e- Phase-------------------- Permit Fee $1.00
Motors------------------- HP-------------------- Phase--------------
Motors----------------- HP . Phase------------- ...... H P
-------(........ Charge.---....----- / D
/
harge----- ---------
I TOTAL FEES
R 0 D IF INSPECTION APPROVALS
Fixtures ------- --------------
Rough Wirin2-2y.�4 . ..... ---- -- - ---------- -
A,
AT IATE tTon
...0,--------
PKCTOR
),�`Ns- T
Finish Wiring INSPECTOR
Motors ------ ----
O r INSPECTOR
Final ---------------------
? ?AT& INSIECTOR