2561 2,003 / ST vows Oreee 61vd.
NO. STREET LOT NO.
PJAN
RPII)C� R ,ELECTRICAL PERMIT
ca 0 1964CI F CUPERTINO
Date Permit No.
II��! Fce S Ob
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
�y City of Cupertino, and all other laws applicable thereto.
`V
Use of Premi P<
c _
V
;.a Owner SQA/or /'q
aal5 /Nc Address Sf 5 r� S.,r ,
y By C Address 9
CONTRACTOR, AGENT
Approv
ny^' Phone: aSZ—/000 ELEC[RIGL INfTH
1"
NEW RPL FEES
Size Service Conduit......................Number �,f Outlets---------------- ---------- --------- -.............
Size Service Wires-------------------------Number of Switches------------. ----'----- ----- ----I
I.....----
----
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------- ---------- -------- - .-------...---
Misc7NC'1p JC-----------------------Dryers.. --------- ----------- ------- -
Motors---.....--......... HP.---------.----- Phase................---- Permit Fee $1.00
Motors-------------------- HP_..........._._.. Phase....................
/ otors- -- HP .. .���--------------------
- --- -.. H P Charge.-.......
TOTAL FEES
—° RECORD OF INSPECTION APPROVALS
Rough Wiring....... T-E..... . . ... Fixtures ......................
..... ........_... ...
DATC INSPECTOR 0.1T[ IXSR[CTOR
Finish Wiring ........... .. - - ... Motors ... ..-..--- -" ---'-------------
DATE INSPECTOR I
Final .... ............•---'---�-
OA L INSPECTOR