2699 /O V o 43
NO. STREET LOT NO.
w a 11R ELECTRICAL PERMIT
0 7 CI OF CUPERTINO
33 /APR 24 1964
= 29O '' 0 Date 195— Permit No.
° ' CITY OF CUPERTr l( Ffe �,tj. do
> �
<m Application is hereby made to the City of Cupertino for a permit to install electrical
m = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
LL wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
5 City of Cupertino I other laws ap e thereto
03
0a
J Use of Premises
3 < Own Addres
wsN
w w By _ Address
QO /LCONTRACTOR,7AGENT Approved —.
—U Phone: �T �L/J J ELECTRICAL INSPECi01
I
State License: 0 Sd-7 5
NEW RPL FEES
Size Service Conduit----------------------Numbs:-of G tlets..........----- -- ---....-
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-----------_...
oto s-------..- -- -------- --- Phase------ ------- H P Charge- ----------...
TOTAL FEES i
RECORD OF IN9PECTION APPROVALS
Rough Wiring------------- ------------------------- Fixtures ......................I----.------------
Finish Wiring
DAT[ IMS![CTOR MotorsOAT[ NSR[CTOR
DATE ... T r /
....L.......INSPECTOR Final
OAT tt INSPECTOR