577 ANO. STREET P '-W ./ LOT Ne4k ���?-��� 1•
. . APPLICA y',FOR LECTRICAL PERMIT
'CITY d , ERTINO'
•Date i �'Ut -�' `` 195 ,E• Permit No.
Fee S"Yo
Application is hereby made 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
wiring and/or fixtures in accoidance with the provisions of the Electrical-Code of the
City ofCupertino, and all other laws applicable thereto.
v
Use of Premi
ua Owner —P-- Address 4
;g G Address
CONTRACTOR, AGENT
_ =Approve
Phone 1 - A 31 ;y ELECTRICAL INSPEC7W
�_'•1 °* � NEW RPL fJ'PEES
. . R V X717 l
�Sjze Se.vice'Conduit......................Number tlets .. :..... xti
Size Service Wires--..--------`--- .........N,m er Of 1 tchees.=,,,------..:: ..----:. .:. .... ..............
I _
F .............._..Numher of Fixtures ......Z. . ...
Size Service Switch......................Number of,Receptacles- 1V
.....
Size Sub Feed Conduit '
rSize Sub Feed Wires--------ry-......Ranges??!:=--,,: KW------- -
------ --------- --------------
41 • - . .
. Number of Circuits--.------------.-- Oven -------------- KW..._._...... -.....:... ....:..... .
Number of Meters........................Signs.......... Transformers........ ------.-.. .......... ..............
`'
"Misc.l..............................................Dryers._.................__...------------ -------- --------- ._...-------
Motors.................... HP--------------------
Phase-------------------- Permit Fee.$1.00 S
Motors.....__........... HP-------------------- Phase----------------...
. Motors------'------------ HP'.....................Phase H P Charge_.:..----- - 0---
h TOTAL FEES
RECORD OF INSPECTION APPROVALS
Roug h'Wiring................ ...:........................ . Fixtures ---- ---- ---------- ---------------------------
04TE INSPECTOR OATS INSPECTOR
Finish Wiring ---------------- ....................
Motors ............ �--- ------"-------
DATE INSPECTOR .' �DyTR
Final•��X �...�.
INSPECTOR