2072 (2)H ys'a I �
NO. STREET . LOT NO.
APPLICATION FOR EL CTRICAL PERMIT
CITY OF CUPERTINO
6�Date � , 191-0 Permit No. c2Z>
Fee M -Zc
1 f"o
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.
Use of Premie uy-�'z
a Owner Cy"1A%X1UV L4kA �-
By W
N CONTRACTOR, AGENT
n Phone:
A3dress
Address 50 /
Approved /
ELECTRICAL INSPEcroz
C
Size Service Conduit.....o-.1,..........Nu¢s
r of Outlets ..................
Size Service Wires..... ?�6...........
Number' of Switches-. ... -------
6,
Size Service Switch-----
....Number of Receptacles ...........
Size Sub Feed Conduit..... .............Number
of Fixtures ..................
Size Sub Feed Wires ---..-6 ----------
Ranges ------- J------- KW ..............
Number of Circuits.------. � 0.---
Oven .............. KW ..............
i
Number of Meters ---------- 5............
Signs ---------- Transformers........
Misc--- /s70-� -------------
Dryers ------- '=-----------------------------
Motors------------------- HP -----------------
Phase -----------------
Motors------------------ HP ------------------
Phase ...----------------
NEW RPL Ft F.S
s. 5....
S v
L__' .._..
6,
3
.. .......................
.....80
I
/t2, 30
...
'"
3,00
Permit Fee $1.00 39•Ga
Motors-------------------- HP ------------------- Phase .................... H P Charge---. ....
TOTAL FEES
I RECORD OF INSPECTION APPRQVALS
Rough Wiring�...�.-�..SA' ..... Fixtures ------- -"- ...I ''-- "-
DATE INSPECTOR DAT[ IHSYECTOR
Finish Wiring -------- ..., Motors ....:.------ ` -----------------------
DAT[ IXStCCTOR t OAT J NSPCOTOR
V -71,416 FinalL.--�------7.._....... IN
0ATC INSPECTOR