2156 /0y3y I �O.XOS�rP •_Dr yy iy6zi%' �.
Nb. STREET LOT LOT NO.
Cp 3
12PPLICATION QR ELECTRICAL PERMIT
JUL 8 196JCIT.!OAF CUPERTINO
/ S
Date s4Cp.!'ZIDCDTIt T94a Permit No. 59*
MFee S /2
00
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
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
' v Use of Premises
c /
a Owner S^^ 2 Address U f7o Cow coo A ae�[
i By / Address SU
CONTRACTOR, —AfGENT 1A App roved l l
(� Phone: �— 0741L 41L . E ICAL INSPECTM
�- �'_•,� NEW APL FEES
.+ .
Size'Service Conduit-...n . . Number of C itl s...:.............. _. .
D
n
Size Service Wires........�.Z..-...Number of Swit es................ .../.(1. _........ �-----------
//�� -' I oD
Size Service Switch_1�.Q...�.-----Number of Receptacles............. ...3.4.. ..........
Size Sub Feed Conduit------ ---------Number of Fixtures.................. ..1..N.: ---------- L... S..
Size Sub Feed Wires------.c-....._..Ranges......../----- KW.............. ----- -- -------- ------------
// 7s
Number of Circuits................ Oven ---/....... KW.............. .....L
j Number of Meters------------------------Signs.......... Transformers.....-.. ----//... .......... ...........
Misc.........................................-..--Dryers..----. ..........L-------------- ----L.... .. ----- --------------
M
. 7�
Motors----3---- HP--- Phase. -..{.---------- Permit Fee $1.00
Motors------------ ------- HP...:.............-.. Phase...._.-------.-----
Motors-------------------- HP------------------ Phase-----.....- ---- H P Charge-------------. ..7�.----
�� 00
TOTAL
.PEES
p O OF INSPECTION APPIQVALS
Rough Wirin 7 1 y--_ \...... Fixtures . Jam..- .: - -
8 8--. ... .. --
OATC IX9PECTOR yATE I ER
Finish Wiring -I.. �. - ---�-- -
RATE INSPECTOR ' �M NRPECTOR
' Final ---Y............... - - . .. .................
i DATE - INSPECTOR