2639�n-
$T0.f:[T � LOT NO.
D(MAR 19 996 " FOR ELECTRICAL PERMIT
9k OF CUPERTINO
,
D INO , 1 Permit No. ���
Fee h ���
Application is ereby made to the City of Cupertino for a permit to/ttifEall electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in actor ante with the provisions of the Electrical Code of the
City of Cupertino, and all her laws applicable ther5to.
Use of
Im
Address
/ --1-1--." — Approved LC%JA /UNVT fw
Phone: � eLEMICAL INSPEC[OR
State License;
NEW RPL FEES
Size Service Conduit --------- /-�t-.Number of OuOets ------------------ - ---------- -
Size Service Wires ------------
.-Number of Switches ----- - ---- ------
4/N-umber o , f Receptacles ..........
Size Service Switch ------- - 1110M a - -- ---- ------ - - .......
Size Sub Feed Conduit ------------- ---- Number of Fixtures ---- - ----------- -- ------
Size Sub Feed Wires .................... Ranges ---------- /- KW ---------- --- - -------- ---------- ----
Number of Circuits --------- ..... Oven ------ /---- KW ------ ----- ---------- ---------- ------------
Number of Meters ------- / ---------- - Signs ---------- Transformers -------- ---------- ---------- --------------
Misc---------- ----------------------- ------------- Dryers --------- / -- -- ---- ------ - ------ --- - - - - ......
Motors--------- ---------- HP ----------------- - Phase --------------------
Motors ------------- ------ HP ----------- ........ Phase -------------------- Permit Fee $1.09 -
Motors----------------- -- HP -------------------- Phase --------- - -------- H P Charge -------------
i'l I I TOTAL FEES
Rough Wirinks F INSPECIION APPROVALS -- ----------------
71 'U". A -� - ----- Fixtures , - /.
DA E � In"ECTOR INSPE
Finish Wiring ---------------- I ............... ........ .......
DATt IMSPECTOR 1��
Fma .......