2717 a.
NO. STREW LOT NO.
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Y g ® eI FOR ELECTRICAL PERMIT
0 a ITY OF CUPERTINO
AP 2719 4
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Date 19�.,� Permit No.
LL W
_W CITY � �UPERT,, ' Fee s //.
a Applica ion is ereby ade to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
LL wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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> City of Cupertino, and all other laws applicable thereto.
z_j Use of Premises
J0
3 < Owner Address
— N •
W W By �'yi fes✓ S-- Address SJ
i o ?_ ,CTo , AGENT Approved
- 0 Phone: 4X G-S- 300 - ELECTRICAL INEPECTIXK
State License: - Cl0
NSW- RF: FEES
Size Service Conduit---------------------Number of Outlets...............--- ---.--.._ -------- --------- ----
Size Service Wires--------------------------Number of Switches___ ---------- -.--.----
Size Service Switch........................Number of Receptacles------.--.-- ---------- ---------- --.._--------
Size Sub Feed Conduit----i-****--.----.Number of Fixtures..-/0!r-.-- ---------- ----------
Size Sub Feed Wires-------------------Ranges..--.....---.-. KW------------- ---------- --------- -----------.-.
Number of Circuits------------------ Oven _.--- ....... KW---------...-- ----*--_ -------- -------------
Number of Meters..._.------.------.Signs--.--.... Tran ormers-------- ------_.. -------... -------"--
Misc.-----------------------------------------Dryers--....!o , - --------- ------ -------------
Motors-----------_... HP------------------ Phase----------- - - Permit Fee $1.00
Motors-------------..... HP.--......-'-.-..... Phase--------
Motors----------------- HP-----_---------. Phase.................... P Charge------- ----...--
TO AL FEES
RECORD OF INSPECTION APPROVALS
Rough Wiring------.A---_.-. --- Fixtures ---------------_
DATE IxsrrCT0R OAT[ / IMMECTOR
Finish Wiring .....---_.....-�.........-_-..-.....--- Motors ---- --.-.-_:--..-...
DAT[ INSPECTOR / E�T[ IIS[t[CTOR�
Final ^` "S�
/ DAT[ IXEI[CT0R