2817 '2cS SSA �• o��,'e �e t��s Cmeet�.
NO, ,STREET LOT NO.
a � I FOR ELECTRICAL PERMIT
0 oD OF CUPERTINO
3 U A 16 1964
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I 0
O
LL w Dace. ( , ]9�� Permit No.
C Or CUPERTIIN0 Fee S 3B 'r
a U) Application is hereby made to the City of Cupertino for a permit to install electrical
w
w = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
0 0 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> W City of Cupertino, and all other laws applicable thereto.
Oa 20S!: $.oA S
Use of Premises
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3 OwneCC-<�, Address
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— N
W w By
0 CONTRACTOR, AGENT A COVE
-C) Phone: C d.SS L
pprove
INS►E !
State License: 7 9 ?D J"
�T �
NEW— RPL FEES
Size Service Conduit...�-----:-:3,�2..-Number of Outlets... .. ........... . I. .........
Size Service wires--5P*--:5Cz-^-r Number of Switches..-------------- -- -- --------- ------- ------
Size Service Switch... -.<?-Numl>er of Receptacles............ &Z
--------- --------6.-
t.
Size Sub Feed Co it of Fixtures------------------ - -
It - ------ ---------- ------0-0..--
sen-'-V- I —
Size Sub Feed ....Ranges....... ----- 'K -------------- ---------- ----- ----**--------
Numberof Circuits.----------------- Oven ----- -------- KW-------------- ---------- ---------- --------------
Number of Meters.-------.............Signs.......... Transformers-------- ---------- --------- --------------
Misc------------ -----------------------------------Dryers------------------------- ------------- ---------- ---------- ------- ------
Motors ......... HP-........-.-...--- Phase..---.....--..---- Permit Fee $1.00
Motors -3�Jrk- HP;-------.-------- Phase......... ........
Motors 2r.Z z HP...---------------- Phase------------....... 14 P CIharge-------------- -
I�-�zle
2-- (7 TOTAL FEES
7/ 0 OF INSPECTION APPROVALS
--- ------------- - ----
__jj
PiougKWiring Fixtures
DATE INSPECTOR DATE INSPECTOR
Finish W ng Motors ------------- ---------- .. ............... ............
L
T. T PI TOR
Final. ),X� .....
LDAT[(#-- INIFICTO.
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