2536 'O. STREET LOT NO.
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APPLICATION FOR ELECTRICAL PERMIT
1g TY OF CUPLRTINO
3 < � _ I DEC 19 16103 t3
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Date ^� ^^^-1� Permit No.
Fee S'P'oo
a Application is hereby made to the City of Cupertino for a permit to install electrical
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
0 w City of Cupertino, and all other laws applicable thereto.
i� Use of Premises
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3 a Owner �^ _ ^^� - '� Address -
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w w B _@ _ Address
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a o 3195 "MENS'CREEK RD. Approve
– U Phone: SAN I(1eP rAIFELECTIUCAL INSFE��f3
State License:
_ NEW' RPr FEES
Size Service Conduit..3---.'---------Number of Outlets. --------------- -4 ../ -�
Size Service WiresS00McMl ALNumber of Switches....__........ 1�Y.....
._...
Size Service Switch_A"a.�!A4--Number of Receptacles............ .C.— ----------
q
Size Sub Feed Conduit.. ..............Number of Fixtures------------------ ---------- --------- ..............
Size Sub Feed Wires..#4-----------Ranges----4--------- KW.............. ..14----- ------- - 2- -.rcJ
Number of Circuits-3.4........... Oven -------------- KW.............. .......... .
Number of Meters...7----------------Signs---------- Transformers........ ........:- -------- --------------
Misc----------------------------------------------D ers...--------- ---------- ----
Motors._/:�-----.. HPFRAsn„µ,.A Phase.....--- ------ ----- Permit Fee $1.00
Motors. l------------. HP._7�--- ---- Phase............. -
... -
Motors...- - ----------- HP......-----------.. Phase------------------_ H P Charge...---------- -- �.00
UTOTAL FEES P.
C-, O - OF INSPECTION APPROVALS
Rough it ng7_,R f.!-fti:.- Fixtures _- -----.- RSPEC, DAT[ INSPECTOR
Finish Wiring .�.. ..... .... Motors ---------- . *--..--�-----------------...........
OS', INSPecTOi D"KINSPECTOR
Final ........ .....
.......................
➢RE INSPECTOR