2762 Q S LOT NO.
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APPLICATIO FOR ELECTRICAL PERMIT
LL MAY 4 OF CUPERTINO
O J 2 2 196
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LL DaCITY OEMMPAT-542 195— Permit No.
0
< Fee S 5-c30
< - Application is hereby made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
r wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
00
> m City of Cupertino, and all other lases applicable thereto.
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z J Use of Premises
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3 a Owner ���- `Q Addres
HEATH ELECTRIC
w w By Address
0 a L@as@raI4S'o AAtf6MNIA
o Approved —_
_U Phone: ELECTRICAL INSPECTOR
State License• ld zUn ^-cz
Phone ELgato G-4422
PLm RPL FEES
Size Service Condui .%.........Number of Outlets.................. �
Size Service Wire�/-------------.Number of Switches--------------- -- ----- .......--.--
Size Service SwitchrUw�9----Number of Receptacles.........._ ...... ... ..... __ ..__...._--
Size Sub Feed Conduit--------- -------Number of Fixtures.................. ..........
Size Sub Feed Wires--------------------Ranges......./------ KW----------- --------- ------- --------------
Number of Circuits--.'--------------- Oven .....L...... KW------------ ------- -----.....
Number of Meters........ Signs.......... Transformers-------- ---------- -_._.... ._.;-P Mise--------'- �-�-=�-----'-.--..Dy� ers._/------
----.._-------
-------- -------
Motors ------ HR {test Phase------ ------------- Permit Fee $1.00
Motors-------------- HP-------------------- Phase......... -------
Motors-.--......... ..... HP-- --------------- Phase.......... - ------ HP Charge-------....... ./%AD
TOTAL FEES
t O OF INSPECTION APPROVALS �S D
Rough Wiring. .. ---.`�'�.. �Km-�---------- Fixtures - -----.. ...... .
O T[ \ INSPECTOR D/.TE MSR[CTOR
Finish Wiring -------.--- ------:. - ..- Moto
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Final .... ....'--- -.. ......�- ----------....----------
D [ IR[P[CTOR