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NO.• SC EET ��1+�1 It LOT NO. „
N
r p o R ELECTRICAL PERMIT
3 u` � FEs 1 19641 cupxruao
0 Date 13 195— Permit No. �`�9
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G1 CUPERThNO Fee SOjq-
a 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
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wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
5 w City of Cupertino, and all other laws applicable thereto.
zj o a M162Use of Premises
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3 a Owner l '-'-ae el'�Z
Address
- G Yr�T a o �n 1 'U • 1+q`U tu.
w w By Address
Q O •� /�COoN�T/AAACTORr AGEN Approve - -w`
- 0 Phone: / /�7 / / ELEC UCAL� H S►EQ01 Y
State License: 2107� U
_ NEW _ REY. FEES
Size Service Conduit......................Number of Outlets..........--...... 5r--- ---------- .-�-8a
Size Service Wires--?o W---------Number of Switches------- _------ .2. --- ---------- .. -x.°---
Size Service Switch_??04---------Number of Receptacles------------ .°33
. ._ -----..... ..............
Size Sub Feed Conduit_---------------Number of Fixtures.__............. .72q"....
.... ._...._. .. _...
Size Sub Feed Wires-------------------Ranges----I----------- KW------------ --------- -- ------ -...r..-'f.
Number of Circuits__Y ----------- Oven ----------- KW-------------- ---------- --------- -------
Number of Mpeters......................Signs.......... Transformers..-.---- ---------- ---------- --------------
Misc.-- ---/I 1'a�-------ry-----..Dryers...-...... --- ----------- -------- ---------- -�.C0-
--
Motors--..._..---...-... HP--.......------... Phase....--..------- Permit Fee $1.00
Motors. . HP------------------ Phase-...'.-.----.--
Motors--------- --- -- P- ------------ base 7 H P Charge 1 ,• 0 3
Clj�� TAL FEES r2 . �O
RECORD OF IN PE ION APPROVALS
Rough Wiring------....I.....�--------------C-------- Fixtures :---- DATE -��--�----....------�--.....---
DST[ INSX[CTOR /� DATE IXS![CTOR
Finish Wiring ..--.--------- . . --- Motors --. ------ _................
�- - - / � - ---- -
DXT[: INSPECTOR �j T / C�S<r=D•v
e V Final 1 .�.....
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.1 DSTL INSPECTOR