2220 NO. STREET - LOT NO. .
.0
o A,�PPL'tC ITA O'AIaFELECTRICAL PERMIT
r< JUL 19 1AHruPExrlNo
M Date . . _ -11� Permit No.
I� 1
um� r ur Lu t ! 1RU Fee $ Iy 6s
\� Application is hereby made to the City of Cupertino for a permit to install electrical
V wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
p wiring and/or fixtures in accordance with the provisions;of the Electrical Code of the
O City of Cupertino, and all other laws applicable thereto.
V1 Use of Premises _ QS` A-C r' e
Owner U�� F- v�� VeAddress nl.O C
By c, c'�cvLAddress 7rC
CONTRACTOR, AGENT
_p _ Approved
Phone: O ELECTRICAL INSPECROl .
Yy� a
,I NEW RPL-- --FEES
pl -- -
Size Service Conduit...................._Ndmber of Outlets.................. .�./.. .-......_L..- _._.._o
I . (Size Service Wires--------------------------Numberof. Switches_............_ �.. . z�.
I
L"
. :.........
Size Service Switch..._---.-.__.-._....Number of Receptacles............ .3....- ---------- --3..
q /o
Size Sub Feed Conduit.................Number of Fixtures.......------
... .. ......... ..aS-. .....
Size Sub Feed Wires--------------------Ranges........,!'..... IKW-.----.-- ------1.. .......... ............. . .
Number of Circuits--------_------. Oven ---/---`--- KW-------------- ------J. -------- ----.
Number of Meters.........................Signs---------- Transformers-------- .-------. --------. ------
Misc... -------------------y- ----Dryers.............1...�.-- I �S
Motors------.�.�.- -_... HP---- -2------.. Phase.......--/_
Motors-------------------- HP---!................ Phase---.-.......1------
Permit Fee $1.00
Motors.................... HP-------------....... Phase......-----r---.. HP Charge-.---_-----_L_�.a .
I
�
TOTAL'-FEES c
CO INSPECTIONS /APPROVALS
Rough Wiring..... . I=-. ...
- --.........totms
Fixtures ---------------- ----I----------...............ATE IX SPECTOXI GATE- ,IXSPECTOR
Finish�Wirin ........:....... -------------------:. ..._.....-- - ^..-;
DATE INSPECTOR1SPECTO
inal .... -- ---......�--- ---......_------------
-,OATS INSPECTOR