937 (2) NO. STREET (� LOS NO.
D PC A1� t R) ELECTRICAL PERMIT
JAN 12 13 T CUPERTINO
61
Da t2 , 195— Permit No. 9,37
lv� o Fee $,
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 applicabl ereto.
v Use of Premi
c
:a
Own r —" 1'f�L¢ Address �Qs�..{�.�/✓/ —u
ro By kwvI—A D k Address ��
CONTRACTOR, AGENT
Approved
'C Ph.ne: oL —/ EL CfRI L INSPEC101
NEW RPL_,., FEES
Size Service Conduit:�-f{.........-_.Number of Outlets..............
Size Service Wires.............Z--------Number of Switches.......-/----- -------- - ........_L.............
Size Service SwitchA --��-------Number of Receptacles ...
Size Sub Feed Conduit..................Number of Fixtures-.. ------------- ---------- ---------- ------------ .
Size Sub Feed Wires---'----------------Ranges......---------- KW-...----...-.. .
Number of Circuits------------------ Oven ............ KW------------ ------- -------- -.----------
Num lof Meterg..............Mns---- ---- Transformers..... ..... ... ..............
/.PU
Motors.................... HP-------------------- Ph e----------------.
Motors-------------------- HP..........--------. Phase-------------------- Permit Fee $1.00
Motors-------------------- HP--------------- Phase---------------- H P Charge........------- ---------
TOTAL FEES-
RECORD OF INSPECTION APPROVALS
Rough Wiring.. . .. � .......................---. Fixtures ----------------------I---------/l
DATE INSPECTOR DATE
Finish Wiring ...... `
DAre INvccrDR / _./ '
I'Mo.tors
inl(C='.---(0.1- ! r
�_!
DATE 7 INSPECTOR
I, the undersigne0- do hereby certify that I ,.IT,
the o-mer and occupant of the cing-Ie family duelling at
for which T an: making
application tD d.) work as a home owner,
I also certify t. at I caill not hire any nor-1`_.cei sed .
/Et ,-A", or ccntractor, but will do this work m�se�f,
TELEPHGl?E 'tdL7 BL;R SIGH?A^URE
ELECTRIC SERVI E NOTICE OFFICE
COPY
� "3UILDING INSPECT R'� OPPh.B r
CITY OF CUFF, TjNO
To
................... w• - -...P.(-R.. .......... 1961....
Y are he reb Y o c n�auth ' t ct the E�CTRIC s i e for
Owner or Tenant ------------- '----- ----
No.. of Wires ......Z............ Size of Wires _ ..._ Size..of Switch �Q..�.
Motor Load............................. Voltage ........-------......----... Phase...........................
...-----
HeatingLoad ........................ K. W- ---------------------------------- Voltage ......... ......... ............
1 Light ..............1t0 ..._40 New Service---- --._....._Reconnect ._._..._----
No. of Meters -.......[..........
Heat ..............220 ......... . ..Three ire ... ...__......Move Service ---------
No. of Add. Meters ..........
Power ........._.. Th hase.. ...........Move Meter ..._...._.
l M1
loa i/bo-son" ' ELECTRICAL INSPEC R