274814- If ,
NO. STREET LOT NO.
OR ELECTRICAL PERMIT
MAY 20 1964 OF CUPERTINO
Date]95— Permit No. O
CITY 0 Fee'3.S
Application is hereby made to the City of Cupertino for a permit to ins all electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, arLd all other laws applicable thereto.
Use of
Owll�r
.(gyQ%—
CONTRACTOR, AGENT
/(State LicenseeI _e-rb'a ¢A
Address �/^i`�J—c'rLtro"" ""�, /elr.
Address
Approved
ELECTRICAL INSPECTOR
. NEW RPL FEES
Size Service Conduit ......................Number of Outlets ..........----
._-- ----
Size Service Wires -------------------------Number of Switches ----------------
Size Service Switch --------------------- —Number of Receptacles............
Size Sub Feed Conduit -------------- ---Number of Fixtures ...................................... ...... -------
Size
....„Size Sub Feed Wires -------------------- Ranges ....._/----- KW...----- -.-.--- ..---„-
Number of Circuits ................... Oven -------------- KW....--------- ---------- ------- ------
Number of Meters........................Signs.......... Transformers ........ ... ...---- ---------- ----.--------
Misc------._...----------------------------------- Dryers, ---- --..--- ............ o2.O d
Motors -------------------- HP .....— ---- ----- Phase --------- .._....... Permit F e $1.00
Motors------------- HP -------------------- Phase -------._.......-
Motors --- ------------- HP -------------------- Phase .................... HP Charge--------------------------
�2 vzCG C..,6iA� TOTAL FEES
RECOREY OF INSPECTION APPROVALS
RoughWiring -------------- ------------------------- Fixtures ...................... --- .....-----_------- --
g OATE I - IXS[E C T ON - - SECTOR
Finish Wiring ......_--.-.._ Motors .............. .. -
OAT[ INSPECTOR 1 q� � % �, +x ST[CT ON
Final --------- - Y� I C.t! �At...--------
OAT[ INSPECTOR