2828 NO:' 5 BEET � LOT NO.
N Q r ti—
o AICON FOR ELECTRICAL PERMIT
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�' `rr� OF CUPERTINO
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= LLoDa195— Permit No.
O a p��p� Fee S
a w GGVcatQFis GUF>L4YajNgPe 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
0 o wiring and/or fixtures in accordance w' provisio Electrical Code of the
> a City of Cupertino, othc a s pli ble the eto.
z Use of Premises
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3 < Owner IUee5 e 0(3
wz By �T (3/d.le � l Address
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o
O
CONTRACTOR, AGENT Approve
LELIAI
—0 Phone: 2S -— v 2- INSPEC
Siate License:
NEW RPL FEES
Size Service Conduit......................Number of Oi, lets..------_------- --------- .......
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------------ -------- ------ - ---------*
cui ----
Number of Circuits_---------------- Oven -------------- KW--- ---------- .------. --------- --------------
Number of Meters------------------------Signs---------- Transformers:------- -- --
----
---- ------- ---
Misc------------------------------------------------Dryers--------------------------------------- - ------- ---------- --------------
Motors----- -------------- HP-------------------- Phase---------------
Motors---.-..-.._-----
-------------------
Motors------- - ---------- HP---------------- Phase-..-----.-.--.- Permit Fee $1.00
Motors----------------- HP----------..._-- Phase............_..._. HP Charge-------------I----------
TOTAL
harge--- - ------ -- ------ --
TOTAL FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring......0.AT[
AT-E----- --------I-N-S?-E.C-T-0-R........ Fixtures ---1-AT1----- ;..;-.CT-O-*
Finish Wiring .......... -------- Motors ----- --------
Final ----7 .... INSPECTO'R*-------