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APPLICATION FOR CERTIFICATE OF OCCUPANCY
OR CERTIFICATE OF COMPLETION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•build ingCcDcupertino.org
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESSL APN It t) I DATE�,l b � 5 I •- �I I `�
OWNERNAME � LA LA PHONE 6261?61l E-MAIL
STREET ADDRESS I I� 1 CITY, STATE,ZEPa.Y VL FAX
l �
CONTRACfORNAME 1 PHONE /;S`''G6 a—�U6 E-MAIL
(, L
STREET ADDRESS ZJe�5 v,1 CITY, STATE,ZIP � 0 FAX
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACT NAME 1,0
A 'A �[,\ PHONE /L D^�O[� E-IIIA I.�I _0 WJY� � CW4•
�j�STREET ADDRES7 �Vj--C�,_, SJ / CITY. STATE.Z[P1/ �n Ja } 9(�r FAX
LIST ALL BUILDI G PERMITS ISSUED FOR PROJECT:
PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE
NUMBER _ QATE DATE F ALED
1 vI .2it,I(sN7 hrnpla�,p�rjh Jslnik
2 I�o� �t�� `' �4 1 �12�I1 iLLL)/Y\�r.liDCu-Aa►lLlLr1 gide- %14W 51(r
3
OCCI,jPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1 1 l
2
3
4
BUILDING DATA:
#STORIES 9 STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRLYKLERS
BELOW GRADE ABOVE GRADE FLOOR AREA LOAD RE UII2ED YES OR NO PROVIDED YES OR NO
H PARKING 4 STANDARD/COMPACT #ACCESSIBLE
REQUIRED PARKING PROVIDED PARKING PROVIDED
- OFFICE USE ONLY(To be completed by inspector of record)-
SPECIAL STIPULATIONS OR CONDITIONS:
CofO Applicarion.doc revised 08104111
INSPECTION WORK LOG - ONE PER PAGE DETAIL FORMAT PAGE-001
PRINTED ON 10/24/12
PERMIT NUMBER: 11070184 10919 N WOLFE RD CUPERTINO
PERMIT TYPE: 1M TI MERCHANDISE TENANT IMPROVEMENT
USAGE CLASS: II/III B, II/III B, IV-HT,V-B NEW
SPECIAL :TI-JERKY KING(RETAIL) REMOVE WALLS,DOOR, INSTALL
PERMIT :NEW WALLS,DOORS,LIGHTS,SWITCHES, PLUMBING FOR
CONDITIONS:BATHROOM,SERVICE SINK,HANDSINK,ADJUST SUPPLY &
AND NOTES :RETURNS, INSTALL CEILING TILES. NON-STRUCTURAL.
PARCEL ID: 31605051. 10919
LOT: BLOCK:
SUBDIVISION:
OWNER NAME: CUPERTINO VILLAGE LP
OWNER ADDRESS: 3333 NEW HYDE PARK ROAD #100
CONTRACTOR ID: 24319
CONTRACTOR NAME: BRIAN E ROONY
CONTRACTOR PHONE: (408) 294-6325
INSPECTION TYPE: 516 FINAL BUILDING
INSPECTION AREA: .
SCHED DATE: 02/24/12 INSPECT TIME:
CONTACT INFO:
INSPECTOR: JG GREEF, JEFFREY
INSTRUCTIONS: 925- 768 - 8342 - DANNY(BSM CONST)
COMMENTS:
RESULTS: PASS FAIL CANCEL RE-FEE FAIL CODE:
NOTES:
PRIOR INSPECTION RESULTS:
301 ROUGH PLUMBING 11/22/11 P JG
303 ROUGH MECHANICAL 11/22/11 F JG
304 ROUGH ELECTRICAL 11/22/11 F JG
305 FRAME 11/22/11 P JG
308 SHEETROCK 11/29/11 P JG
314 T-BAR CEILING 12/19/11 P JG
505 FINAL ELECTRICAL 01/18/12 P JG
507 FINAL PLUMBING 01/18/12 P JG
508 FINAL MECHANICAL 01/18/12 P JG
516 FINAL BUILDING 02/24/12 P JG
516 FINAL BUILDING 01/18/12 F JG