2755 NO./ Q LOT NO. I
o APPLICATI !:FOR ELECTRICAL PERMIT
o � 'S 'MAY 22 1964 .,TY OF CUPERTINO
3u
LL W D tATY n "^`+r� , 195— Permit No.
0
e Fee 5 16-10
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a Application is hereby made to the City of Cupertino for a permit to install electrical
W z wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
j W 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.
ZJ
Use of Premises
J 0
3 Owner 'e^ �/ ��"� Address
w i HEATH ELECTRI
W W By _ Address
i 0A; tlkN1A Approved
—V Phone: —E�vr-.v,r rn.5EEf3Iri�
State LicensePhone ELgato G-4422
_ N
/j EW RPL FEES
Size Service Condu{p4..'_C._.._Number of Outlets-.--------------
Size Service Wires.. RfZ..Number of Switches.........._._. �-- ---------- -------- -_--
Size Service Switch._1�� 009—Number of Receptacles............ _.__... ---------- --------- _.-
Size Sub Feed Conduit------------_ ...Number of Fixtures.................. ..__.... ---------- .../ ` �6
Size Sub Feed Wires._................Ranges........- .. KW-------------- ---------- --------- ----..------
Number of Circuits----------------- Oven ...../----- KW.......--.--- ---------- ---------I- 1._c Q l5
Number of Meters----/......:---------Signs........_ Transfowrs... ---------- ----------
Mist._.. Dry -� ----- - - . ---
-.----- ----- --- ---
Motors------�...._ H ��Phase--------_ -------- Permit Fee $1.00
- - - ll
Motors- ------ ----- -- HP-------------------- Phase--------------__ O U
Motors-------.------------ HP......__...-.._. Phase..-------..._..._ H P Charge.-------------
7
TOTAL FEES
o` yg CO 9F INSPECTION APPRO
Rough Winn - ------ ----- -------l__- --- Fixtures -----�--------- - -
8 g �-'- --------------- -- - �---- - .
OA [ ( IMSRECTOR �/ OA� /fMSR[CTOR
Finish Wiring --- . .L. --------- Motor --- ..,... - -- --��-' ��'- ---"'-'--------
DAT[ INSPECTOR �AT / MSR(CTOR
Final ..... .......
O [ IR[R[C TOR