2270 NO. STREET LOT NO. 0
APPLICATION- FOR ELECTRICAL PERMIT
' r os""� F CLIPERTINO
JUL 2 9 19
Date n 4r;,J�-.�L�is ..J. (•..�.a;,c�a Permit No.
Fee S
Application is hereby made to the City of Cupertino for a permit to install electrical
1 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 es_' A,.0 r c'
c
a Owner e ��. �. _o _ Address
By Hill e t e Addressj 17
CONTRACTOR, AGENT
Approved N �
Phone: Q�(_oELECERIaI7 INSPEG703t
NEW RPL FEES
Size Service Conduit......................Number of Outlets........... ...... .g4l. .......... ... ------
I v1 ya
Size Service Wires..................._-...Number of Switches_......_...._ - .. . .......... .... .....oi�b
Size Service Switch........................Number'of Receptacles.---.--.- -3------ 3. 0
ja
Size Sub Feed Conduit------------------Number of Fixtures------------------ .'2//.. ---------- --
Size Sub Feed Wires...................Ranges.......---- KW......-.-..--- ----- -- ---------- -----,/--
Number of Circuits-----._----...... Oven ---/..... KW.............. ..../. .......... .......
Number of Meters........................Signs........... Transformers........ ........//.. .......... ..............
Misc
ransformers--------
Misc.............................................--.Dryers-----{----------
HP......�/Z......
Motors...... Phase- ---
Motors.......q--------- -------- Permit Fee $1.00
............. HP.................... Phase--------- ---------- 00
Motors.........-----.... HP-------------------- Phase.................... HP Charge...------------I----/.....
95r
TOTAL FEES
0 OF INSPECTION APPROVALS
Fixtures ----- ------------- ----- -- -----------------
Rough Wiring IP-:7 7
OATS NSPECTOR
Ar I DATA
Finish Wiring ................I------------------------- Motors ......------- ... A:'........ ..� .. ....
DATE INSPECTOR S TOO
Final ................... ...... - ---------------------
DATE INSPECTOR