2591 ao�GG
NO. STREET LOT NO.
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RELECTRICAL PERMIT
° 131961T� cuPExrlrao
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'. 0 Date — — � � '?,11'95— Permit No.
° < 6ur. J Fee tiO c)
<m Application is hereby made to the City of Cupertino for a permit o 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
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> m City of Cupertino, and all other laws applicable thereto.
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3 Owner Lf G P�eceC�� ,� Address-we'-V �l l7pi�-'ice o
- Z By R/�dEiv�i�F 'e> Address i �o B Poflo fluo otr
0 CONT= TOA, AGENT
Approved
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—L) Fhonr r ���� �� ELECTRICAL INSPHC702
State Licenser 93 N 9 (�4—'
.. 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 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-----...-..........
Motors------------------- HP------------------ Phase........-------... H P Charge----------------I-------------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring......--------- -------------------------- Fixtures ----...------ ---- ---....--..._.............
oATIINS[[cTO. o.1TY INsr[cTOR
Finish Wiring ------........�. .. . . . ... Motor
- ----- - -----�---
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Final
01T INSRI<TOR