583 1 n6o i
NO. STREET LOS NO.
A,PPU k%T[ON FOR ELECTRICAL PERMIT
U ff��=y, b OF//CUPERTINO /� p
Da 2y_ 60 194'0 Permit No. `� V
1-ce /
}� rfTlllatisn s hereb'}� Fq�ytte City of Cupertino for a permit to install electrical
((� wiring and%oi fixtyures as �sted n 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 Premis,q e oM OW e,. d /q'
u
a Owner — Address
ro ByAddress
r. CONTRACTOR, AGENT
�j Approved
Phone: �/ ` Z Crav [GL INSPECIOt
NEW . RPL FEES
Size Service Conduit......................Number of Outlets............... .......... ......... I.........
....
Size Service Wires.........................Number of Switches--------------- ---------- ---------.I..............
Size Service Switch------------------------Number of Receptacles------------ ---------- ---------- --------------
Size Sub Feed Conduit..................Number of Fixtures.................. .......... .......... ..............
Size Sub Feed Wires..'-...............Ranges..------------ KW....-------- --------- -------- -.------------
Number of Circuits-....."----------- Oven ------------ KW-------------- --------- ....._--- -------------
Numb f Meters..-. ns.......... Transformers........ .......... .......... ..............
..
Mist----- . ..�s.....-- --------- ryers.--------------------------------- --------- ------ -----------
Motors--------------------
---. ------Motors---.--------------- HP.................... Phase...... ............ Permit Fee $1.00
Motors.................... HP_.............---. Phase.........-------...
Motors.................... HP.................... Phase------------------ H P Charge-------------- -----
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring.-----...-"'... ---------------------------- Fixtures ------------------=-I---------------------------
DAT[ INSPECTOR DATE INSPECTOR
Finish Wiring . . . . .... Motors ............ .... I.._. .....
• DAT[ INSPECTOR r' �T ' / IMSEEOT�
Final u. -.J.....L "'n
` ATS ( INSPECTOR