2002 19979 SfeU�uS �HeeK_
NO. STREET LOT NO,
fIAPPLIC—ATION�iFOR ELECTRICAL PERMIT
AY6 1963OF CUPERTINO
Date �3 195— Permit No. ` L
MIT OF L � N0 Fee S 3r s0
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
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
y Use of Premises— E'S�cuY l,sWfSS /x �hJ
° r Y (aNFB
a Owner C /� /y��� ,fs��7 Address SrP r
e Address P
1 //�(C(ONTRA/C�TOR, AGENT
Approve
— Phone: V/-1• 'y /
Eie r. r
NEW ,RPL
FEES _
I
Size Service Conduit----------------------Number of Outlets--.--..----.-- ---- __I-----
..._I- -----------
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-3---- Transformers—!; - --------- ---------- --------------
Misc------------------------------------------------Dryers---------------------------------------- -------- ---------- -------------
Motors------------------- HP------------- Phase--------------------
Motors-----.------------ HP----------------- Phase------------------. Permit Fee $1.00
Motors-------------------- HP--- -...--- ---- Phase-------------- H P Charge--------- -- - -
- - ----
TOTAL FEES 3T I .Sd '
RAV-INSPEcriON APPROVALS
Rough Wiring--- .-.I..........-------------- Fixtures -------------- -I--.._. ._...._---
--- --
DATE INENECTON DATC NS"E T..
Finish Wiring ...._.A........ . . --. Motor .. _I ... ..
_DAT[ INSPECTOR
Final -----.. ........ ... ............._......_.....
DAT[ IMSNCCTON