2662 N A ST LOT NO.
Ji
D APPLICATfO FOR ELECTRICAL PERMIT
/MAR 2 7 1964 OF CUPERTINO
Dab ' inl`) , 194 Permit No. 2
Fee Sa; a 5
Application is hereby made 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 �.
'0 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Premisps
c c
a Owner Addrest o
By _ AddressF Md)c d y6 s
CONTRA TOA,33 AGENT
�7 c-- Approved
Phone: /%�� ' �V ELECTRICAL INS►8C[03t
S
NEW RPL - FEES
Size Service Conduit.............._.._..Number of Outlets.... _ .Y -... . ..I-�--- -
----
Size Service Wires.......................... of Switches_1....... --------
- _..... I----- .
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------Z--- -------- HP.---�---------- Phase--------------------
Motors-------------------- HP.-.7--.--------- Phase------------------- Permit Fee $L00
Motors------ ---------- HP----- ------------ Phase----------------- H P Charge................ ^/
A ^ TOTALJ
� � ', O �Q� INSPECTION APPROVALS
RougH�irin��..�. .: . .L....�lW... .. Fixtures
---- -------------
----......... ..... .
.AT, INSPECTOR DATE INSI[CTOR
Finish Wiring ....:........... ...\... fMoto'S
.......-------. =� : . ...----
DATE INSIECTOR I_ AT OISRECTOR
Final ..�I C�
............ ..... ......................
.. .... .'---
DATE INSPECTOR