897 ELECq9 1122 -'ac"
NO. STREET T
LOT NO. L�
APPLIC� FOR ELECTRICAL PERMIT
C :OF CUPERTINO
Date 19IL Permit No.
Fee $ O
Applieatio is eb ;Rlw of Cupertino for a permit to install electrical
wiring a flllues a� s lisd on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Prem
Owner
V
BY
4hone:
Address
Address
Approve
ELECTRICAL
�? .
Size Service Conduit ----------------------Number
of Outlets ------------------
Size Service Wires -------------------------Number
of Switches ----------------
Size Service Switch .......................Number
of Receptacles....--......
Size Sub Feed Conduit..................Number
of Fixtures............----..
Size Sub Feed Wires -------------------- Ranges ---------------- KW .............
Number of Circuits ................... Oven -------------- KW --------------
NEW RPL FEES
Number of Meters ------------------------ Signs ----------
Transformers---.----
----------
----------
--------------
Misc.-----•------------------------•----------------Dryers----•-------------•----•-•-•------------I------•---
----------
--------------
Motors
HP
Phase
....................
Motors ....................
--------------------
HP --------------------
-------------------
Phase --------------------
Permit Fee $1.00
Motors --•-•---------------
HP ------
------------- Phase --------------------
H P Cha rge.--------------- I ----------•--
TOTAL FEES-
RECORD OF INSPECTION APPROVALS
RoughWiring ----------------
--•-----•------•------•-----
Fixtures ---------------------- •---------------------------
DATE
INSPECTOR
DATE INSPECTOR
Finish Wiring
-------•---------------otors
------------- ......... ----------------------------
DATE
INSPECTOR
DATE INSPECTOR
Final ---- ...... - ---------
DATE INSPECTOR