2749 10409 ►gym-liF— -L-C AVE _
NO. STREET LOT NO.
w 2
?IIMIAY
r oN R ELECTRICAL PERMIT
3 20-1964 cE cupexrlrao
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'.0 Date Zd 19� Permit No. _-!27
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< Fee S o1
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<m 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
�. wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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5 City of Cupertino, and all other laws applicable thereto.
iJl/J
Use of Premises SIiU6C_e— f—AMiLI/ SBS
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3 a Owner -1-D-IMI` E—P Address 1040q 471A,6ViLu5
W w By GxSfG—LC-I C(-Ee-TrZL Address /5E2 QV
0O CONTRACTOR, AGENT Approved
—U Phe, ELECTRICAL INSPECTOR
C- 1O
Siate License: 1 6425 2 GO
T
_ NEW RPL FEES
Size Service Conduit--------------- ------Number of Outlets------------------ --- ---- ----- .... ......... ....
Size Service Wires--------------------------Number of Switches.____ ..... .. ----- --------- ..........-.--
Size Service Switch------------------------Number of Receptacles------------ ---------- ---- --------------
Size Sub Feed Conduit...............----Number of Fixtures.....------------- .L. ' 00
Size Sub Feed Wires--------------------Ranges---------------- KW------------ ------- -------- --......------
Number of Circuits..........--'---- Oven .............. KW------------ ------- ---------- -------------
Number of Meters------------------------Signs.......... Transformers------- ----------
Misc------------------------------------------------Dryers------------- ---- .........------------ ---------- ---------- -----------
Motors.....----d-------- HP--3,/W------ Phase----/--------------
Motors. H Phase-------------------- Permit Fee $1.00
Motors- --------. H ......--------. Phase.....------------- H P Charge---------------- .......7.
1 / TOTAL FEES 5
01p OF INSPECTION APPR S/
oug�Wi ng-- -- �...: ------------------. Fixtures .L -.---- ......
/ INSPECTOR T IXSL[CTOR
Finish Wi ing ../ L �Ln.---------.- Motors ..-_ .. ---- "�•"
/ --- -• -- -------- ------
Dri[ IRSX[CTOR • TLTOR
Final ----__---1............ ----------
/ DAT& IXSL[CTOR