2643NO. STREET LOT NO.
R ELECTRICAL PERMIT
f
Cl F CUPERTINO
AR 1919643
Date � , 1 Permit No. � 6 X
CITY OF UP T'rNr F c e S /C:;?-
App ication 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 Premigeq
c n
a Ownet�� Address
Address
� CONTRACTOR, AGENT
/: Approved
Phone: EL¢CTRIUL INSPCCI01
•
NEW
RPL FEES
Size Service Conduit..Z��57/-....Number of
Outlets ------------------
- ..........
....
Size Service Wires_..._ .. ------ Numbei of
Switches:.......__....
..... hp ---------------
Size Service Switch.._/_Mz¢..... Number of
Receptacles....._.....
. _—_ ..Q. ----------
--
Size Sub Feed Conduit ..............Number of
Fixtures ------------------
- IK ---- ----------
-
Size Sub Feed Wires ------- . ......Ranges..__.......... ... ............
KW .............
_....1..
---------- -----
Number of Circuits-------'- ..... Oven __. ...........
KW-----------
----/-
--------- ----.J.-.JJ
------
Number of Meters ........................Signs..........
Number
Transformers........
----------
---------- --------------
Misc ........ .............. ------ Dryers
Phase Motors
& ----------- H P :�
-----
--- ---
-- - ------
_- -------- -----
Motors ----_-------------- HP_ -_-------------- Phase ---------
----------
-- ---
----------
Permit Fee $1.00
Motors -------------------- HP -------------------- Phase -----------
-------- H P Charge-------------_
/� c10
p
TOTAL
FEES
I
0 OF INSPECTION APPROVALS
Rough Wirinj - ---------- -------Fixtures .--'----...----.....1---....------------'
.A,
'N ..
FinishWiring .... ........... ------------------------
motor
- -
-- ----_------------
PATE lmlptcyo.
Final
mstfexp
-----------------
INSIECTOR