2539 NO. STREET LOT NO.
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x o `APP =KATION FOR ELECTRICAL PERMIT
3 � 9 1963CITY OF CUPERTINO
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LL w Date. - -• •-----^ , 195— Permit No.
0 ~ CI I Y ur �;urth �.d
Fee S
a m Application is hereby made to the City of Cupertino for a permit to Install electrical
W I 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
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5 m City of Cupertino, and all other laws a able thereto. DC,
z_j Use of Premises
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3 a XOwner �"""'� '4 Rddress ��/B "�
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w w ' Hy - _ Address -
— COACTOR, AGENTO Approve(
fOVed
7 39 �V�,Phone -S�S� _
ELECTRICAL INSTECrOR
State I icense2 5 3 g 2 p !I
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NEW RPL FEES
Size Service Conduit......................Number of Qitlets------------------ --------- -----...-
Size Service Wires-----..... ..............Number of Switches---------- ---- ------- -------- ..............
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-------- --------- .---.._. --------------
Misc._'-----------------------------------------Dryers--- --- ------- ------- ----...------
Motors.-...--..--------- HP.................... Phase---------- ---- ---- Permit Fee $1.00
Motors------------------ HP.................... Phase--------------'---
otors ....""/—y/�HP---- ' ----- ------ --- H P Charge....---------- - ....._n
,(fXjZl P� ��_TOTAL l) d
RECORD OF INSPECTION APPROVALS
Rough Wiring---------------- ""--------------------- Fixtures ----------------I--------- ------......--
➢AT[ IXf�[CTOX DATA tX [CT.,
Finish Wiring .....I........................?Final
Motors ........- -- ---- - .---- --'-.................
DATE txvmrD[ / T[ fx [ r
------ =..- ...._�----
➢AT[ INS.[CTD[