562 5�} STREET LOT NO.
APPLICATION FOR ELECTRICAL PERMIT'
R
1TY.OF CUPERTINO 1.
Da Z9 A , 195 ermit No.
z . .
/ ' 2kis ereb,}' made to the f f • for a permit to install electrical
wliflnanc6r fitfsCa�l�' t side hereof, and agrees to install said _
1 wiring and/or fixtures in c ' ITT e provisions of the Electrical Code of the
.City of Cupertino, at nia s applicable thereto.
_ v Use of Premise
;5 Owner- Address
v
N BY Address - 1 V
CONTRACTOR, AGENT
- 'Approved •' .�
•,Phone: — ELHCTR(CAL INEPEcroR
NEW RPL FEES
t'/
Size &1;�I:5�c nduit----- .........Number of Outlets.......24�...... .1.6.. .......... ........0..0....-
Size Sjvi6e Wires.....AE.�..........Number of Switches---------------- ---i...('.. -- ----
Size Service Switch------IC-b-A,.....Number of Receptacles............ . -- ---------- ----DI.Y.6.
Size Sub Feed Conduit------------------Number of Fixtures-------.._------ -- ---------- ----
;
Size Sub Feed Wires...........7p._--Ranges....... KW-------------- ---------- ---------- -------
Numberof Circuits------------------ Oven .............. KW----.......... .......... .......... ..............
Number of Meters.......................Signs.--------- Transformers--..--- --------i. .......... ...............
Misc...... I I 'XS—
.......... ...................-- -----Dryers...-..-----------------_------...'--- ---------- ---------- --------------
Motors.*:---------- - :. HP..... Phase-------------------- Permit Fee $1.00
Motors.................... HP---1--------:------- Phase....................
Motors---------:------- HP-------------------- Phase-------- ---------- H P Charge...------...: ....LOA
TOTAL FEES'
7 INSPECTION APPROVALS
R.o ...... .. Fixtures ----:----------
- ---- ---- ----------------
INSPECTOR
.�ghWirinj TOR DATE
FinishWiring .... . ..................... Motors ........................ ----------------------------
PATE ["SPECTOR DATE
-------------------------- ---------------:-------
%DATE INSPECTOR
�l ,,YV JOSE
� � I = �• , poi
^f. I I
Ba shore at Oakland Freewa .Son Jose,'.- Y___.. Y. sCalif..- Phone CY re`is.7-1201,'
1 _�j M1•
i
t