2572r /0080 PomoV / An!£
NO. STREET LOT NO,
C FOR ELECTRICAL PERMIT
® OF CUPERTINO
(j 1944 23�7�96� �
Date , 19� Permit No.
o31'-00� � ati Is hef a e 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
�p wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
n
v Use of Premise, L.MmjeleC 119 L
c q
a Owner/ &PE,2iNo BtKf �/{oP Address �aa80 os' liy. ,LLCP
roByC11PcS�//VO c,,2/C .✓C, Address �'0 ia1Av �J
CONTRACTOR, AGENT
Approved
�^ Phone: -2.S.2- /000 ELECTRICAL MSrecloa
1!56—
YJ
,7
NEW - APL FEES
Size Service Conduit......................Number of Outlets.....-_--.....--- ..w--- _----_-- ---- --
Size Service Wires.........................Number of Switches._____---
_."L--- ----------i-/__-O O
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------------------- HP.................... Phase H P Charge------------ - ---------
TOTAL FEES 1 --3. 00
RECORD OF INSPECTION APPROVALS
Rou h Wiring--....D
irin ......DA---..-. . . Fixtures .------------------ �-----
% % �.........: EC----- -OAT6 IXSP[CTOE OATE IXS�[CTOR
Finish Wiring -'..:"'.......'�. ---- Motors ------- D
--.
DATE IXSEECTOR , ./ ro[
Final "�,�C---t------I------
DAT[ IXSPECTOR