2616 2oGc {;
N NO. , STREET- LOT NO.
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APPLICATION FOR ELECTRICAL PERMIT
�� i(':ar� 996 IT 116F CUPERTINO
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LL w DateT9KY Permit No, �^
O < Fee Sot('�0
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a Application is hereby made to the City of Cupertino for a permit to install electrical
r wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
W wiring and/or fixtures in accorda e with the provisions of--he Electrical Code of the
00 O> N City of Cupertino, and all other s aPXA f�leA 414,
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zUse of Premisce ��-- ��a:1. ���rz�"=,�
J O 61,
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3 < Owner Address (n O I T.l�t« C�`,llr/? !
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W W By �el� / «�- _ Address
(1. CONTRACTOR, AGENT
a o / Approve
ELECTRICAL INSPECIW
2 State Licenser S '2 ')f __—
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NEW OIL - FEES
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Size Service Conduit4.:i<-------------Number of Outlets....... a.... ... W
X-D
Size Service Wiresl -_�i'�� Number of Switches.._____.... /-,.s...... .......... ...I----:7
90
Size Service Switch.............._........Number of Receptacles............ ./9--- ---------- ----I---------
Size Sub Feed Conduit-_ ----------Numbei of Fixtures_____._..... 6�.7. .......... .
Size Sub Feed Wires.... Ranges................ KW.._.......... ..._..... ---------- --------------
Number of Circuits................... Oven ............ KW------------- ---------- ----------- --------
Number of,,Mqers------�?..............Signs.......... Transformers-------- ---------- ------ - -***- -------
Misc.-------. - ----
------- --Dryers................... ......... -------------- ---------- -
Motors..... H-P-77,6-----__ Phase........
Motors------/------------ HP-----7.��-------- Phase---- Permit Fee $1.00
Motors.....e-------------- 4P I .......577 ---- Phase --------- H P Charge..--......-'--
-------
TOTAL FEES
r--l�"-RfYW6f_NSPECTlON APPROVALS
u h Wiring------E.ST
-I----- --------I-K-SP-9-C-T-0-R-------- Fixtures _j...... --------- ------ ----- -----
Finish Wiring ................ ........................ Motors I... -----------0---------
t 4ECTOR
UG V414-X'� IN....... Final
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0 e�L,? DA I INSPECTOR-