2815 O �
No. srarrr Ior No.
N Q
r.g LITtON FOR ELECTRICAL PERAAIT
0 �, TY OF CUPERTINO
sU0 JuL 151964
i ° 02 /c7
Da - 195— Permit No.
° a Fee 5
U) tc isNPERTMcOhe City of Cupertino for a permit to install electrical
ring anor fixtures as listed on the reverse side hereof, and agrees to install said
a wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
yCity of Cupertino, d all other laws ap icable t fkt
o <
z-t Use of Premi
° P, aA
3 < Owner "Y - Address
w w i By - � Address dL
0 CONS TRACTOR, AGENT A PP roved _
_
—V Phone: / ELECTRICAL INS►ECCOX
State License: 1 .
• NEW RPL — rEE9
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-------------- ---------- ---------- --------------
1
Number of Meters........................Signs.'.. ransformerormers._ .... .......... ..........
Misc.-----.._..---------------------------Dryers..................-----.............. .......... .......... ..............
Motors----------- -------- HP-------------------- Phase.................... Permit Fee $1.00
Motors---.---.------- HP-------------------- Phase..
Motors....-------------- HP--------------- Phase......... .......... H P Charge-- ........L.-.......d-6
TOTAL FEES—
RECORD
EES
RECORD OF INSPECTION APPROVAL
RoughWiring-----.......... ............. .............. Fixtures ............. ..... ................_--......--
OAT[ INSPECTOR OAT 1 "TOR
Finish Wiring ......._....... ........................ Mot . .. ----�------ ---.........
DATE INSPECTOR
O [ ct
Final .... ............ .. ---
OAT[ IRf R[CTOR