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O. STREET LOT NO.
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I
R ELECTRICAL PERMITf �
3 DEC 11Q ,,63CI SOF CUPERTINO h I
° Date 1� Permit No.
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° a UrtK , Fee $
a NApplication is hereby made to the City of Cupertino for a permit to install electrical
* I wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
00 wiring and/or fixtures in accordance with the provisions of the Electrical Code of t e , ff
m City of Cupertino, and all other laws applicable thereto. V-3 LA
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Use of Premises
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3 a Owner N0 4.1 `� CIP F4 11 crd. Address
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By DFG MAS tGfe7A/C Address ^� �'k '��s
Q 0
CONTRACTOR, AGENT Approve
_U Phone: e lH� /V 3� ELHCTRIGL INSPH
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State License: 12 30 1!V __—
NEW RPL• FEES
Size Service Conduit. 4............Number of Outlets.................. .c�.q.. .......... ...
Size Service WiresF.-I." "0.1. Numb& of Sv�itches................ .&./... ....... /P
... ............ .
Size Service Switch."PA�?..Number of Receptacles............ !26 /,?-.6 0
........ ...I...... ..............
Size Sub Feed Cc)nduitI..c..........Number of Fixtures.................. ......... .......... ......:.......
Size Sub Feed Wires:!!k.A�...Ranges..,� ......... KW.............. .......... .......... ...0?.0
Number of Circuits-'................. Oven ......:....... KW.............. .......... .......... ..............
Number of Meters....7.................Signs.......... Transformers........ .......... ......... ..............
Misc...............................................Dryers...........'A*. .....*.......... --- ---------- -------—
Motors.-14......_..... H PF?PA�.?Z,!%A4Ph as e...../.. .........
Motors...R{...----.•--.. HP.7r.-S.At?7(.?Phase_..L...of....... Permit Fee $1.00
Motors.................... HP.................... Phase.... ............... H P Charge................1 7...qP
d TOTAL FEES X,315�0
COP OF INSPECTION APPROVALS
Rough Wiring Fixtures ...................... ............................
DATE INSPECTOR
Finish Wiring ................ Motors ............. .......... ------------;...............
DATE DATE INSPECTOR
Final .......................... ............................
DATE INSPECTOR
Multi-House Electrical Inspection Card
Electrical Permit No. .....------------------------------
APT. ROUGH FINISH
NO. WIRING WIRING FIXTURES FINAL
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120.
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119 1/63-500