1281 Io o 1
NO. � CLT� LO? NO.
_ ELECTRICAL PERMIT
ffMI81WIT CUPERTINO
Date / j)5— Permit No.U11I
-- - Fee
Application is hereby made to the City of Cupertino for a permit to nstall electrical
Jwiring and/or fixtures as listed on the reverse side hereof, and agre 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.
v Use of Prenu r w1 T-4\Q Q-0 k Z1
Own Address k
By Address G4'1\
iEAC
Approved
EYECIRIUL [ SPECIbl
NEW RPL FEES
Size Service Conduit......................Number of Outlets....:.........._. --19 --I
- -------- I---
Size Service Wires........................:.Number of Switches..:.-....__... _l.�._ -
_.. I-u
Size
witches-:----------
Size Service Switch........................Number of Receptacles--------------lV.. ... ...... ..
------------
Size Sub Feed Conduit------------------Number of Fixtures------------------ J-2--- ---------- ----
Size Sub Feed Wires--------------------Ranges................ KW------------- ---------- ---------- --------------
Number of Circuits................... Oven .............. KW.--------- -- ---------- ------ -- --------------
Number of Meters........................Signs.......... Transformers........ ---------- --------- ..............
Mist-------------II-ii-
----Dryers----------- ------ ---------- ---------- --------------
......... Phase....
.Motors.......
H P Permit Fee $1.00
Motors-------------------- HP...../........----- Phase--------------------
Motors-------------------- HP.................... Phase--------------- ---- H P Charge-----...-------- -�:`.
TOTAL FEES
RECORD
harge----------------
TOT-
RECORD OF INSPECTION APPROVALS
RoughWiring......----..... ............................
DATE INSPECT.. Fixtures .........ATE--------- ------- SIEC.T.4-------
FinishWiring ............... ..................... Motors --------:.... I---------- .............................
DATE INSPECTO. ✓ �INSPECTOR
Final ........................... ...........................
DATE INSPECTOR