2657 NO. STREET LOT NO.
N Q
r o P I R ELECTRICAL PERMIT
0 a C F CUPERTINO
iii ??7 1964
w ate/ // ����
a� w Date � 193�� Permit No.
° a �T�/ nF ,n'UPE (1�tl' Fee S
i m Apj541h i n rYhereby ftRT'e Oty of Cupertino for a permit t all�ectrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
j a wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
o °
5 0 City of Cupertino, and, 11 other laws applicable thereto.
o_j Use of Premises
3 Owner /G �1 �u� '�t� Address
a
w Z B 7XI�aw°n,�O, hlrar�n�r_ y: nore�nr _ Address
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NTRACTOA, AGE T
¢ a C[�1
a O � ncm ar��J benLU$ Approved --
- l) Phone: SAN JOSE. CAI IFn PNJA ELECTRICAL INS►ECTM l
Cypress 5:0644
State License: (-' /6 IZO�S/
NEW EPL FEES
Size Service Conduit......................Number of Outlets.......... . ........ ........-. ......... .--.
Size Service Wires..........................Number of Switches------------ --------: -------- ..-------..--
Size Service Switch------------------------Number of Receptacles---.-------- ---------- --- -.. ...._..------
176
Size Sub Feed Conduit..................Number of Fixtures.. --------------- .��... .......... ...... ...
Size Sub Feed Wires....................Ranges---------------- KW----------- -------- ------- ---......----
Numberof 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------------- ---------
TOTAL FEES •�O
RECORD OF INSPECTION APPROVALS
RoughWiring................ --------------------------- Fixtures ------ ----------__1 ----------..._..--'--
DAT[ INSPECTOR DAT[ INSPECTOR
Finish Wiring ......-Dere---9..... ........1u...recro....-V-0 .. Motors oerE .---I-------.w...------
R sr[croR
Final -----------------------I----------------------------
DATE INSPECTOR