2842 C_ c2P4 Ks d ,A j�2 Q_ `f
NO. STREET LOT NO.
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r o � OLOR ELECTRICAL PERMIT
AUG 19 1964OF CUPERT1C10
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0 Dt, 195— Permit No.
LL FOF ll
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a 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
LL wiring and/or fixtures in accordance with the provisions of the Ele rical Code
D
00
y City of Cupertino, and all other law applicable thereto.
03
z j Use of Premises I C ! I �'=�'-2 �'
3 Owner : �'`1��� Address
W = s
w w By Address
OCONTRACTOR, AGENT A [OVe 1�• ,� /
I� Phone: PP 4ELECTRI L rNSTECIVt�
State License: /U\
_ NEW RPL FEES
Size Service Conduit......................Number of Outlets------------------ ---------
Size Service Wires--------------------------Number of Switches--------- ---._ _-------- .
Size Service Switch........................Number of Receptacles...-------- ---------- ------- --------------
Size
------._.._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................. !
... -"------- ------- '�5
--------..-
Motors--------- ------ HP-------------------- Phase-------------------- Permit Fee $1.00
Motors------------ ..... HP------------------- Phase-------------------
Motors---------------- HP---------------- Phase-------------------- H P Charge---------- -7---- -
TOTAL FEES [
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- ---------------------------- Fixtures ---------------------�...-----__...---------
DATEINSRCCTOR DATE IRSR CTOR
Finish Wiring -------------- ----------------------- Motors ............. ----..— - ----
GATE MSRECTON Fina " T[ I TOP
------------
V I
------ --. �" - ----...
OAT- INSPECTOR