2605 zoE.0� 7 I So - - -
NO. STREET LOT NO.
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o a ECTRICAL PERMIT
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® Y" ITY, OF CUPERTINO
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n w Date 141 L Permit No.
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�� CUPEY
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TWO Fee 5 7
a A o i hereby ma e to the City of Cupertino for a permit to installelectrical
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w = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
j LL wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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> 0 City of Cupertino, and all other laws applicable thereto.
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z _j Use of Premises
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` �L� r/`�NGel' Address
3 0 Owner
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w Z /g(-aid �Z i• �il��u. /coi 3yRti�, CUf nNc.
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a CONTRACTOR, AGENT
0 s Approved
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Phone: Z y �- S S1 CL� ELECfRIU
State License: /,P) 14 " e' / 6 6Z�'
_ - NEW RPL FEES
Size Service Conduit----/All.........Number of Outlets.........___ . .
Size Service Wires.......v----------Number of Switches................ .
Size Service Switch....IVP........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.,&AV------SIS O e Lf----.......Dryers-------------------_...--------------- ---------- ------- ---/-�-
Motors.................... HP----------_...._ Phase..... Permit Fee $1.00
Motors.......------------ HP-------------------- Phase........_......
:...
Motors-------------------- HP--------------- Phase--------........ H P Charge.----------...- ------------
TOTAL
--------TOTAL FEES 2'
RECORD OF INSPECTION APPROVALS
Rough Wiring------....9..... . ... Fixtures ....----.-A,
- ,-
-.-A ----....
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DAT[ INST[CTOR OAI /ITOR
Finish Wiring ---------------- ......... Motors . .........
DAT[ IRIT[CTOII
D TIE INS[[CTOI{�