2599 NO. 5'r0.EET LOT NO.
N Q
20 NR ELECTRICAL PERMIT0 CU
F CUPERTINO
FD
�FEB 211964 ^ _
o Date 195— Permit No. oc 'S
I ` C,ITY OF CUPERTNIQ lee
U) App kation is hereby made to the City of Cupertino for a permit to testa"" Il electrical
w wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
a wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
3 w City of Cupertino, and all other !atvs livable theset6'� yA'
z Use of Premises
o
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3 a Owner �'� Address 6r2 Q " 63
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By Address i
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0O �CO"N�TRACTO{RR,,-�AAGENT App roved
—0 Phone: C ✓ '-� �" " U ELECIAtUL tNSPEC[OR
State License:
jji
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------------------ ---------- ---------- ----------
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-------- ---------nH.P.................... Phase
....................
...........--------
AL-tors _rF�PLi'I�t/�L 'c — .........TOTAL
Charge-.�
(�/// TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring--------------- ............................ Fixtures ----................. ..-...---_..----
DATE INSPECTOR DATE MSRSCTOR
Finish Wiring . ..... ......................
Motors ------- ---------- -- ....----.........
DATE INSPECTOR ,q----- T R
Final -- l u -- ------ ---------------------
D INSPECTOR