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NO.. ETRE LOT NO. '�`
w 0 ELECTRICAL PERMIT
0 I P CUPERTINO
33 APR 27 9964 �-
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Date 1256,L' Permit No.
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(, PF--, Fee Sr. Z0
< 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
4 wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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5 City of Cupertino, and all other laws applicable thereto.
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z Use of Premises Ll
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3 � Owner Address a
w w By Address S C
f CSO TjAYWRJ_AGENT
o ^^ /6 G APProved __
— U Phone: 4 X SO ELECTRICAL INS►8C101
State License: /J1 8 a/ ' C110
NEw RPL FEES
Size Service Conduit----------------------Number of Outlets............... -- ------_.. . -------- ------- ....
Size Service Wires...._..---------.----..Number of Switches................ .----- ---------- ------- ------
Size Service Switch...........-------------Number of Receptacles..._....... .......... --------- ----------...-
-- Z.VSize Sub Fed Conduit....._---_------Number of Fixtures. '
Size Sub Feed Wires------------------Ranges........------- KW-------------- ----- -------- --------------
Number of Circuits................... Oven .............. KW.----------- -------- --------- -------------
Number of Meters------------------------Signs.......... Transformers-------- ___---- ---------- --------------
Misc..------- Dryers......._ _ _ -------------------- -------- ------ ---...------
Motors--------............ HP .. Phase---------_-.----_ Permit Fee $1.00
Motors------------------ HP----------------- Phase--------------------
Motor - -
- HE .. - Phase-------------------- H P Charge---------------- ------ -------
U, TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring---------_----- --------------------------- Fixtures ...................... --------------------- ------
DATE INSPECTOR DATE INSPECTOR
FinishWiring ................ ......._.--........... Motors ------------ -------- ------------------------
DATE INSPECTOR DATE INSPICTOR
Final ---------------------'-- ---------------.....------
DATE INSPECTOR