2571 'NO. STREET , LOT NO.
o . ,I FOR ELECTRICAL PERMIT
o < OF CUPERTINO
3u �JA 22 79 4
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Date / � "� � ]95— Permit No.
CIV OF CUPERTtNlfl. Fee s / 3.5
a Application is hereby made to the City of Cupertino for a permit to install electrical
F wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
00 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> w City of Cupertino, and o ler laws applicable thereto.
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3 a Own ' Address
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d NTR AGENT \
a a ` ,O Approved _.
u Phone: /r• ELECTRICAL INSPECTOR
State LicenstlG
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NEW RPL_ FEES
Size Service Conduit......................Number of Outlets--------- --------
-
-�
-f
Size Service Wires--------------------------Number of'Switches_-------------- �-'D `��
---- ..__.--- ---
Size Service Switch..-_...................Number of Receptacles............ `3-a 3 'J-0
9 ......... .. ..
Size Sub Feed Conduit------------------Number of Fixtures------------------ - . - �---------- --- ,--eo
Size Sub Feed Wires--------------------Ranges---------------- KW------------- ---..._.. ------- -- -------7�r
Number of Circuits-----------_----- Oven ....-- ..... KW------------ ------ --- --------- .....
Number of Meters........................Signs.......... Transformers-------- ---------- -
Misc- -
- --......--t- --......-------... . ..........-----------------------------
Dryers -- ----- .--71
-- ------- ---...
Motors--.....-.'T-...- HP---------�-------- Phase..... .............. Permit Fee $1.00
Motors-------------------- HP-------------------- Phase-----------------_
Motors
-------- ------
Motors.................... HP-------------------- Phase--------- .... H P Charge------------ --
•'� NO
TOTAL FEES
CO OF INSPECTION APPROVALS
--------�- --------------------- Fixtures -- -----------------�------_......._------
OAT[ ------
OAT[ IMSI[CTOR OITE INSPECTOR
Finish Wirin ••------------ ----- -------- -
� -- --.....---.?Motors -------------........... ---------
�...: ------------
DATE INSPECTOR f�Jl[ IR
Final
➢I [ INSPECT.
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