1215 ELECT PERMITl vagSLI T---: E SFi'rasz
NO. STREET LOT NO
ELECTRICAL PERMIT
CI CUPERTINO
f Nov 1 1961
Date , 195— Permit No. r
�Y OF CUTERTINO Fee
Appli n is hereby ma e to the City of Cupertino for a permit to instal e e ical
wiring and/or fixtures as listed on 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 s applicable t eret .
Use of Premig- �� � ��✓� ` ,.
a Owne '' / Address
i
By _ t' "'== AddresCLEC.TRIC.AL
CONTRACTOR, AG13NT Approv
ne:'� -?� %INSPECPOi<
NEW RPL FEES
Size Service Conduit......................Number of Outlets ------------------ ---------- I ---------- �._____________
Size Service Wires -------------------------Number of Switches ---------------- -------- - ----------- --------------
Size
-
Size Service Switch ........................Number of Receptacles_ ---------- ---------- ---------- --------------
Size Sub Feed Conduit ------------------Number of Fixtures--.--.-.----..---- ---------- ---------- ---------
Size Sub Feed Wires ... -............... Ranges ................ KW -------------- --------•- ---------- --------------
Number of Circuits ................... Oven .............. KW -------------- ---------- ---------- --------------
Number of Meters ........................ Signs ---------- Transformers --------
I---------- ------------------------
Misc-------------_-------------- ----------------- Dryers ----------------------------------- ------------------------ ••------------
Motors---•--••------------ HP -------------------- Phase ----------_------• Perm'
Motors .................... HP ---------------•---- Phase ------------------
Motors .................... HP -------------------- Phase -------------------- H P Charge--------------
TOTAL FEES ig�t
RECORD OF INSPECTION APPROVALS 1
Rough Wiring ----•--•-------- ---------------------------- Fixtures ------------------••-- -•------- -%j - ---------
DATE INSPECTOR DATE 1 SPE OR
Finish Wiring _------------------- otors .-.._-- ___-. -. .._
DATE INSPECTOR DAT
Final //_C .�.�_.. ..... . ------
-
INSPECTOR