1936NO. STREET
LOT NO.
APPLLIIC�AT'{IO�N. FOR ELECTRICAL PERMIT
D � [ Of CUPERTINO
Date IMOR a 5— Permit No I+C
Fee ti J
App iy`.,'Ik�re�1�y/X'�' �r�/,�rh�pry ���jj,{]t�y of Cupertino fora permit to install electrical
wiring X EKQtrEi/� WNW 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.
nn Q_a {. �C,jS�iJ
Use of Premi=ega M M, �,Q CKQ MO 2 �
a Owner
i
,ro .By
Phone:
1 4 9
_
NEW RPL
Size Service Conduit ----------------------
Number of Outlets ............... ...
Size Service Wires -------------------------
Number of Switches ................
Size Service Switch ........................Number
of Receptacles............
Size Sub Feed Conduit ..................
Number of Fixtures.Q.h?.QT I
Size Sub Feed Wires ..........
.........Ranges................ KW --------------
Number of Circuits. ..................
Oven .............. KW...--- -- -.--
I•�
Number of Meters ........................ igns_........ Transformers--. ----
Mix............ n ............................... Dryers ........................................
Motors ....1' .F'<C„HP------ -------- ----- Phase .................... Permit Fee $1.00
Motors ......... ........... HP-------------------- Phase ....................
Motors ............ HP .................... . Phase ---- --- ------------- H P Charge ............ ..:.
Rough Wiring
Finish Wiring
TOTAL FEES �s
INSPECTION APPROVALS �j
— Fixtures ...................... I ---
INSPECTOR
DATE