2631 Z < 2 R i _ LOT NO.
W o &4 T I OR ELECTRICAL PERMIT
3 ` ?MAR 16 196a ' of cuPxrlrao
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� w Date —795Permit No. �
° < CIT I Fee S
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
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wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
5 0 City of Cupertino, and all other laws applicable thereto.
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z J Use of Premises
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Owner AA� f��, Address �OS76 Sc lwQrl
w W By r� 0 2 i u n ' 1f /t _ Address / N .vo
aa CONTRACTOR, AGENT approved -
-U Pho.e: /0 00 ELECTRICAL iNSPECrOl
'y7 State License: 7 -
NEW RPL FEES
Size Service Gonduit-J-9--------Number of C),itlets ----.......... ------- ...... ------- ----
Size Service Wires.:....... .............Number of Switches...------------- -- ------ ---------- -------------
Size Service Switch--/0.0-A.—Number of Receptacles.........._ .. ....... ......... ............
Size Sub Feed Conduit----- --- - ------Number of Fixtures------.._-------- ---------- --------- ..............
Size Sub Feed Wires...................Ranges...--/...._` KW...8----- -------- --------- -----f-7�
Number of Circuits------- ---- Oven -------------- KW----------- ---------- --------- ..............
Number of Meters.........../-----....Signs---------- Transfprmers........ .. --- --- ----.0
Misc------------------- ---------------------------Dryers------------------ -
Motors-------------------- HP----------- -------- Phase--------------------
Motors-------------------- HP.................... Phase-----------------— Permit Fee $1.00
Motors-------------------- HP---------.......... Phase. .......... H P Charge.........---- -------------
TOTAL FEES-
RECORD OF INSPECTION APPROVALS
Rough Wiring------------...I--------I----....0.`-------AT X K 5 P 9 C T R Fixtures ... -DAT-E--
- 0 0ZS
DATE IKSPKCT(
Finish Wiring ................I.................. M t ----- ---- ---
Final --------- -- -- ---- ---
OATINSPECTOR