2692 //9d
n � sr r - •LOT No.
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OFOR ELECTRICAL PERMIT
o PTA
Y 'OF CUPERTINO
w LL APR 21196
0 Datc
]95— Permit No. ��
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0 a CITY OF Fee `' \ ?,o
a 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
j 4 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
0 0
City of Cupertino, ^and all other laws applicable eto.
W�/�V 1'C.�1✓
z J Use of Premises Y
J Z
3 a Owner "`''m' _ Addresd
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w w ByApr/j'/ - f / _ Address
G CONTRACTOR, AGENT
o Approved 1
-0 Phone: ;24-4-31000 ELECTRICAL INSPECTUQ
' 'State License: 190 �9O —
NEW RPL FEES
Size Service Conduit......................Number of &tlets------------------ ---------- .
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---------------- --
otors-------------- -- HP -- --- Phase--------------- H P Charge........_----- --- -'------
TOTAL FEES b
'0,0
RECORD OF INSPECTION APPROVALS
Rough Wiring.......AT------ ---- Fixtures ......... ....... ..
DATE p5P[CTOq T[ NSP[CTOR
Finish Wiring --------....... ..................... tFinalMotors -;, '-- i' -- �- -......
DAT[ INSPECTOR P�,[ [q EToq
------- - -- - --------- iJ....................-----'
I DA ` INSPECTOR