1659 (2) NO. STREET _ LOT NO.
® LC:$' OR ELECTRICAL PERMIT
UPERTINO
s � r
Date- r PA J962 , 2Permit No. /
Fee
Applit-I
n T /��
Y hff, f Cupertino for a permit to install electrical
wiring and/or fixtures as liste�ff on t iI e reverse side hereof, and agrees to install said
wiring and/of fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other"laws-applicable thereto. -
v. Use of PremicP< �::4: ..u.�-lc.��,-r-� '-
c
a Owner. L'11.� ���� tie �.✓�,' Address � -
:9 . By Address .
h ' CONTRACTOR, AGENT
a� Approved
Phone: ! - 2 -�i'4 G 7' - ELECTRICAL I77SP¢CTOR
NEW 'RPL FEES
Size Service Conduit----------------------Number of Outlets:----------------- --/J... __------..1..2:d
-4 A/
Size Service Wires---- -
----------------------Number of Switches----------- ---- -------- ---------- -----;L-Y.r?
Size Service Switch........................Number of Receptacles............ ...2-------- ---
Size Sub Feed Conduit--------- --------Number of Fixtures...._.........._ - J... .._...-- ----
Size Sub Feed Wires---------- -------Ranges....I---------- KW.............. .... ..... --------- ----------76
Number of Circuits-- .............. Oven ---I........ KW-------------- ---------- -------- -----------7.5
Number of Meters.:......................Signs----------- Transformers-------- ---------- ---------- ---------------
Misc----------------- ---------------------Dryers-1------------------------------- ---------- ---------- ---------
'Motors-------P).......... HP.---....._.._.. Phase.. .
Motors-------------------- HP- ------------- ---- Phase-------------------- Permit,Fee $1.00
Motors.................... HP--------------------- Phase-- ----- H P Charge------------- --L-
TOTAL FEES 1/ 3 2��
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- -------------------------- _Fixtures ---------------------- -------------------------'
DATE INSPECTOR � DATE INSPECTOR
Finish Wiring ......:......... -------------... -
Motors --- --------------------------
PATE INSPECTOR,
Fin
----� OAT[FT% INSPECTOR
ELECTRIC SERVICE NOTICE , °OP),
BUILDING INSPECTOR'S OFFICE
At ' CITY OF CUPERTINO /
....�i��,1:7...............
...... 196 41
To
You are hereby authptl'z' 'to connect the EL C IC nice for
Owner or Tenant ..... .. y... .. ..jQ/
At . Q ...........
+`No. of Wires -----_:.--- Size of Wires �;�. .... Size of Switch
Motor Load -------------.... --- Voltage ....:::...:.......... .......... Phase..... ......................... ....
Heating Load K..W. ------------------ --------- ... Voltage
.' 11Ligh[ ._...........n0 ...� ...New Service _.`..:.`.......:.Reconnect
No. of Meters ...../..........}H eat....:._.._..120 .... Wire-------.-----------Move Service ..........
No. of Add.Meters ..........4((44411 Power "
...............: r Ph .__......_Move Meter .._........
l/
ELECTRICAL INSPECTOR
104.7/61-50o ,,