2554 NO. 5TRtET OT-NO.
E o F ELECTRICAL PERMIT
3 a JAN 2 1 UPERTlfdO
64
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Date 13h• 2 196-9— Permit No.
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LL F CITY OF CUPERT�INO Fee $
<N Application is hereby made to the City of Cupertino for a permit to Install electrical
w 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
00
> W City of Cupertino, and'all other laws applicable thereto.
z°J Use of Premises �et y �e e p l)A[[ V)
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3 a Owner o' nr a s Address l
w z Ga-t�CUh ('.IeC�hi C Address t i e �� S /h•
w w BY —
QO CONTRACTOR, ppCOV AGENT A
-0 Phone: 1- I 9 ELECTRICAL INS►EC[OI/
r Siate License:�V S��
NEW _RPL FEES
Size Service Conduit---- .........Number of Outlets................. ..3-3... . ....... .S-
-4- i 6
1 .3
Size Service Wires.......... ------------Number of Switches................ .. .3
- ......... _----------
O 00
Size
----------
Size Service Switch......A�R----Number of Receptacles-
- ---------- --------- --------------
Size Sub Feed Conduit-A a----------Number of Fixtures.................. .T---�
- --- ------- - --------------
Size Sub Feed Wires---- ....t--------Ranges--------i------- KW----------- --------- ---------- -----7-i....
Number of Circuits----..JA.A...... Oven ----I--..... KW-------------- ---------- ---------- -74�
---- -
Number of Meters.......1---------------Signs---------- Transformers........ ......_.. .......... ..............
Misc------------------------------------------------Dryers-----------�L :.... I 1. &0
--------- --------- -- - ......
Motors---....3......... HP Phase_......-.-..--._
Motors-------------------- HP----------------- Phase.................... Permit Fee $1.00
-
Motors-------------------- HP------------------ Phase-------------------- H P Charge ---- --------- -------
fTOTAL FEES 19,
RSC OF INSPECTION APPROVALS
Rough Wiring/.'-3-
... .... ----------- Fixtures ---- --- ----------- ------- ---------------
DATE ATE
........ ....
Finish Wiring ....... -;;.;-----------
LIN
DATE INSPECTOR Motors
t AT. ........IN-SP-9-C.T.0.ft........