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2719 zo yJeremit /.�uP t1,— - t� X14 -3 NO.. ETRE LOT NO. '�` w 0 ELECTRICAL PERMIT 0 I P CUPERTINO 33 APR 27 9964 �- W LL O / Date 1256,L' Permit No. > � ! E - (, 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 00 5 City of Cupertino, and all other laws applicable thereto. o a z Use of Premises Ll J � ° Q®�,e —ol rte 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