1640 NO. STREET OT O
FOR ELECTRICAL PERMIT
L40 F CUPERTINO
Date !SEP 13 1962 ' 95_ Permit No. 1 C-- O
��TT��// nJ�
Fee S Z SZ
Ap�fi TY, %a ,e 4NOty 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, an ,i laws applicable t eto.
Use of Premi
Owner c k)ny4z � Address A A /
'rrC�2 B CLj
By AdIre's)(1kek4i,
CONTRACTOR, AGENT
�( ^ [�[/ G Approved
Phone: ^ `- xz r r _ E EC[RICAe IN ECTOR
NEW RPL FEES
Siz& ;c.vice,Conduit----------------------Number of Outlets-------------- - ---------- ...... ---- ------
Size Service Wires..........................Nplmber of Switches-.---------- -------- --------..I_--.----'---
Size
---------
I -- ---------
Size Service Switch----.-PPPPPP..-----.--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--------L--------- -----'--- ---...------
Misc
ransformers--------
Misc------------------------------------------------Dryers------------------- --------
Motors-------------------- HP.................... Phase---...----------
Motors
------- -------- --
Motors.................... HP.................... Phase-------------------- Permit Fee $1.00
Motors.................... HP.................... Phase-------------------- H P Charge----- ---------- ------------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring..-"........... ---------------------------- Fixtures ---------------------- -----------
DATE -------------
DATE INSPECTOR CAVE INSPECTOR
Finish Wiring —............. ............ .. .....tMotors
------- OR
.. .......................
DATE INSPECTOR I-��
Final J0-/--- -------
INSPECTOR