2758 ,4:2 2 -
NO. ySTREET LOT NO.
r o EN R ELECTRICAL PERMIT
o ® CI,
OF CUPLRTINO
3� MAY 22 1964
MAY 2 01964 Sd'
°
4 W Date 195— Permit No.
o < /�
CITY OF CUPERTNO Fee
a a 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
W wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
> w City of Cupertino, and all other laNvs applicable thereto.
z J Use of Premises sI�
0
3 a Owner �� e� Addresses
W HEATH ELECTRIC
w W By Q 0 ox 655 _ Address
a 0 10.fOF4TBR� fAA Approved
—U Phone: _ ELECTRICAL INSPECTOR
State License; X4422
— Phone ELgato G•4422
NZW RPL FEES
Size Service Conduit-/----(ZX------e—Number. of Outlets.-..--------------- —---------- --------- ----
Size Service wirels-5 e5& .....Number of Switches--------- - -- ;0?_�F—- ---------- ------------
Size Service Switch?.I!',P,"'� umber of Receptacles_---------5;rf:5-- ---------- --------------
Size Sub Feed Conduit------------------Number of Fixtures.._._... ---- -- ..2
E,q_
--- ---------
Size Sub Feed Wires--------------------Ranges............... KW..... -- - ---------- -------- -------------
Number
--------------
Number of Circuits._.__........... Oven -----X.... KW------.--.-- ---- ---- ---- -- ------------
C9 CD
Number of Meters...../...............Signs.......... TransforrReF....... ---------- -------
Tr-- ---------- ---------- ---------
Mise.------------------------------------------Dryers- ----- - ---- - ------ - --I
Motors.t-.71..........._ HP---_s�-------�__ hale-------- --- ---- Permit Fee $i.00
Motors.................... HP-------------------- Phase----------
Motors--_--------------- HP-------------------- Phase--------------- ---- HP Charge --------- Ile
TOTAL FEES
COM OF INSPECTION APPROVALS
CTOR
------------------- Motors
Finish Wiring ................I
Rough Wirinj _U�------- Fixtures
OAT[ I TNSPICT .......
t�� I---- -----------------
DATE INSPECTOR ld-� 45�1�cv_R,
Final I_Z�--------I----------------------------
DATE INSPECTOR