2534 NO. $TAE LOT NO.
N 6 ~
PLICATION FOR ELECTRICAL PERMIT
' 0 O
C j CITY OF CUPERTINO
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10
Datet—R_T_°`^19�aT Permit No. _
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Fee $ H t?• �.�
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Application is hereby made to the City of Cupertino for a permit to install electrical
w = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> N City of Cupertino,
and all other laws
applicabl thereto.
z� Use of Premises
J Z
_ O
3 a Owner 2 Address
- N
W w By Address
W
o 31687S�R6@K RD, Approved `
—U Phone; L�!�-9'Wi � ' CALIF. LEaaruc rNare
State License:lq3 O�
1 19
NEW RPE: FEES
Size Service Conduit...4/...L........Numbcr.of Outlets.................. 10. .......... ..
Size Service Wires0>.!s! �Number of Switches................is. :.. ...._.... ..`3
Size Service Switch.-4/0.A.A.exlP.Number of Receptacles............17..,l. .......... 0
Size Sub Feed Conduit.../.............Number of Fixtures.................. .......... .......... ..............
Size Sub Feed WiresJ�ef..........Ranges...5;'.r........ KW.............q..... .......... ...4---75-
Number of Circuits.....4.0.. Oven .............. KW.............. .......... .......... ..............
Number of Meters.../.0..............Signs.................... Transformers........ .......... .......... ..............
M i s c................................................Dryers..................... ................. ..........
D es '
.............. .......... . .... ..............
Motors. II............ HP-AAK !TPZ�. Permit Fee $1.00Motors...q.............. HP...7A.>.-..... Phase......e.0........
C1
Motors.................... HP.................... Phase.................... 1-1 P Charge...............
TOTAL
CTION APPROVALS
Rough Wirin, ... Fixtures
OAT[
AT9 INSPECTOR
Finish Wiring ..... ......... ........................ Motors ... .....................
DATE INSPECTOR
,f9CTOR
Final ... ...... ......I..........
---- INSPECTOR
Multi-House Electrical Inspection Card
Electrical Permit No. ....................................
APT. ROUGH FINISH
S NO. WIRING WIRING FIXTURES FINAL
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