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1115 10601-A I So_ Highway q NO. ,STREET: LOT NO. �I R ELECTRICAL PERMIT Rro'16; 281961 8 �nCUPERTINO J N, Date 1561— Permit No. ktwaa rh RTINO Fee s 3.00 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 .k wiring and/or fixtures inaccordance with the provisions of the Electrical Code of the f� City of Cupertino, and all other laws applicable hereto. Use of Premi v a Owner Cupertino Electiu_C�Nwdress gy C ertino Eleetris I Address P. o,_—Box 616 CONTRACTOR, AGENT Approved AL 2-� 1000 EMMUCAL INSPECT03t NEW RPL FEES Size Service Conduit---------:............ umber of Outlets-------------------- .iD--- ----- ---- Size Service Wires..........................Number of Switches---------------- ---------- . ----------- Size Service Switch------------------------Number of Receptacles....-------- ---------- ---------- -----`---.- Size Sub Feed Conduit ...Number of Fixtures.............:..:. . A... .......... ..1.-0.0. Size Sub Feed Wires.................... ................ KW.------------ --------- ---------- -------------- Number of Circuits................... Oven .............. KW.............. .......... ....:..... ' ...... Number of Meters........................Signs.......... Transformers........ .......... .......... .............. Mist------------------------------------------------Dryers---------------------------------------- ------ --------- ------------ Motors-------------------- HP-------------------- Phase...........----- Motors......:------------- HP.................... Phase Permit Fee $1.00 Motors.................... HP------------------ Phase-------------------- H P Charge----------------I -------- ---- TOTAL FEES--i ? ()f1 RD IFSPECTION APPROVALS Rough Wiri ... . .. Fixtures ---------------------- ---------.------- -------- • ATC �� f OR DAT[ INSPECTOR .Finish Wirin -.. .1... oq DAT INSPECTOR TFin '© .. - [ INf P[CTOR