2588 /a sdPWt
NO. STREET LOT NO.
0
=Y °
PT , OR ELECTRICAL
P
ERSMIT
3 �OF CUPERTIfO
VIFEB
o VY
Date 195— Permit No.
Fce S
a APPTiY � hP RThe� Y of. Cupertino for apermit _UX
r�
/r
to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
LL wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
> City of Cupertino, and all other laa�%s applicable hereto. D
z_j Use of Premises
J 0
J O
3 Owner, Address -
- ,r
w z ]3} f� /' , tLeAddress ;'
OCONTRACTOR, AGENT
-0 Phone: Il/l - 7_ 4,4V 2.c S PP ELECnuCAL rNsreeia��
0 Siate License:421; -35r/- /3l
NEW NPL FEES
Size Service Conduit----------------------Number o. Outsets.--------------- . ...... ........ _.---... ....
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-------------------- HP------------------ Phase-----....------
Motors--------- ----_. HP/-.. -- --... Phase.......-............ H P Charge-----------..-L...----- --
TOTAL FEES d-0
RECORD OF INSPECTION APPROVALS
RoughWiring......-------' -------------------------- Fixtures ------------ ---------------------
OAT[ IMSt[CTOR OAT[ INSPECTOR
Finish Wiring _..... ....... ..................._..- Motors ---------DATE
..._-----------------------
DATE INSPECTOR DATE INSPECTOR
Final -------------------------- ------------------------
DATE INSPECTOR