2525 NO. STREET LOT NO.
E oP,PIp.ICATaON FORELECTRICAL PERMIT
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oIJAF CUPERTINO
D�C 3 Z6, ` 3
LL w Date / 194c Permit No.
° CITY OF CUPERT''N1P Fee 5
a Application is hereby made to the City of Cupertino for a permit to install electrical
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r wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
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wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
5 City of Cupertino, and all other laws applicable thereto.
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z Use of//Premisesp
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3 a Address
W w By Address 100/ Y 1 !u tsf77.U✓
CONTRACTOR, AGENT
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Phone: ss(:7--5-
ELECTRICAL INSPEGIW
1 State License: -P3 y J, e 7 0
NEW RPL FEES
Size Service Conduit----L.Y---------Number of' Outlets._..._.____. - -------- --------
Size Service Wires.......4- - .._------Number of Switches-_._._....._ ---------- ---------- -- ..........
Size Service Switch... ---------Number of Receptacles............ .3.6.. ....__.. .3...6_
Size Sub Feed Conduit------------------Number of Fixtures....._..-------------------- ---------- --------- ............
Size Sub Feed Wires....................Ranges........./---- KW----------- ---------- ---------- -----
Number of Circuits........--------- Oven .... (------- KW--------------
... .............fir.
Number of Meters........................Signs..._..... Transformers.------ ---.---- ---------- --------------
Misc---------------
......... ------
Dryers...---- --
- ------ -- ---- ------- - - -- --- ------ * ----- -
75
--
Motors......... HP------ - ----- Phase-----
Motors-------------------- HP-------------------- Phase-------- ---------- Permit Fee $1.00
Motors-------------------- HP-------------------- Phase-------------- H P Charge----------------I- / O--V
-----.-----
1 TOTAL FE
ff �CIT� OF INSPECTION AEP.40VALS
Rough Wiring..--t
... ..... - --------- Fixture�-----
t .....I-K-S-P E C__T_-0 R
Finish Wiring ................I......L----------- Motors ------ T.V--- _;__ S - -- ----------
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Final
1.51ECTO'k....
DATI .