2701 y, tt0. 5TREET LOT NO. �
Q
r gIJ&Ql FOR ELECTRICAL PERMIT
3 < CITY OF CUPERTIfdO
TRAPOR
24 1964
1 0 Date 195— Permit No.
° a CITY OF CUPERTINO pee S% ° C
U) 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
W wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
5 m City of Cupertino and all other laws ag le thereto.
Use of Pr ises
J 0
O
3 s_ Owne Address" -
N
W W By _ Address
< o �y
CONACTOR, AGENT Approved 1
–0 Phone: eW —19S�/ ELEClA1UL I40EC7 M
State License:�.Z a 7�5 _
NEW RFL FEES
Size Service Conduit......................Num c? oWOutlets.---.--------- ......._- ---------- ........
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.-------------- HP.................... Phase....................
Motors))............./-[,� P---------- - Phase-------........... H P Charge.........-..... -----4L----
�t t�'� TOTAL FEES �'`�
RECORD OF IN ECI'ION APPROVALS
Rough Wiring----------------I............................ Fixtures ..........--------- ------- -- -T-
I -.......
' OAT[ � ' IMSIECTOR DATE S;ECOR
Finish Wiring --'---.........1:............... ..... Motors ----.... ........ .L.....
DATE uv[CTOR Final w c .----I p![CTO I
- --.----i ........
DATE IXSRECTOR