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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•buildingacupertino.org
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS
10561 c�N 1 �c\� ] _ ___ APN# 357-0-;--04-q
5 7—0 S— '7�J DATE lA!O y ZFJ 1 •Z.0 3
OWNERNAME p4 u l- ✓-t '4 z'ft L✓�v PHONE 12-5-06 -2 q2-1 E-MAIL YV
STREET ADDRESS C�V' Q ox, 6 CITY, STATE,/ZIP 1=.x4 QE,p rI NL? &A 9 So/' FAX
CONTRACTORNAME P7"j ] kL Q 4 � PHONE/JZ5-/l-%,.,_h2 q2� E-MAIL t
STREET ADDRESS n` e I 6 ox/6`b l'.` CITY, STATEf;beep---114j1z e A. ISO FAX
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACT NAME ) �{„L (��./T L-P-4 PHONEg 25-6-7,t--2_ ? E-MAIL
STREETADDRESS.. r.0, Qe/� j CITY, STATE,ZIP„lvi 1'' O C� /J� �S FAX
LIST ALL BUILDING.PERMITS ISSUED FOR PROJECT: .
PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE
NUMBER DATE DATE FINALED
> iLU6va�� 3 1-31/AJ Jltzl 13
2
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1
2
3
4
BUILDING DATA:
#STORIES #STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRINKLERS
BELOW GRADE ABOVE GRADE FLOOR AREA LOAD REQUIRED YES OR NO PROVIDED YES OR NO
#PARKING #STANDARD/COMPACT #ACCESSIBLE
RE UIRED PARKING PROVIDED PARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED
INSPECTION CARD TO THIS APPLICATION.
- OFFICE USE ONLY(To be completed by inspector of record)-
SPECIAL STIPULATIONS OR CONDITIONS:
CofO Application.doc revised 05/07/12
CITY OF CUPERTINO BUMPING INSPECTION CARD
BUILDING ADDRESS: 10569 SAN LEANDRO CONTRACTOR:PAUL KALRAPERMIT NO: 12060073
OWNER'S NAME:PAUL KALRA P O BOX 23826 DATE ISSUED:08/03/2012
OWNER'S PHONE:9257872613 PLEASANT HILL,CA 94523 PHONE NO:
FOUNDATION/PIERS/H.D.S. BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH
UFER GROUND '�� RESIDENTIAL ' COMMERCIAL
PAD/SET BACK-CERT 72_
G7� _/_Z_ JOB DESCRIPTION: CONSTRUCT NEW 2 STORY SINGLE FAMILY
GARAGE SLABS/PREGUNITE - . �J DWELLING
UNDERGROUND/SLAB C/ LIVING SPACE 2780 SQFT PORCH 135 SQFT GARAGE 916
UNDERGROUND PLUMBING
SQFT-VACANT PARCEL
UNDERGROUND ELECTRICAL
UNDERFLOOR PLUMBING
UNDERFLOOR MECHANICAL
UNDERFLOOR ELECTRICAL WILDLAND URBAN INTERFACE FIRE AREA ER#
UNDERFLOOR FRAMING VENTS �..r J
TO ARRANGE INSPECTION
UNDERFLOOR INSULATION , '` between 7:30 am and 3:30 pm Monday through Friday,at least 24 hours
before required inspection.Job address and Permit Numbers are needed when
RooFSHEATHING //• requesting an inspection.
ROUGH PLUMBING l 6 r,1Z CUPERTINO SANITARY DISTRICT
TUBS&SHOWER PAN /L Closed circuit video inspection of property line cleanout,point of connection
ROUGH MECHANICALand street lateral required prior to passing FINAL CITY PLUMBING
INSPECTION. Call the District(408-253-7071)for an appointment.
ROUGH ELECTRICAL/POOL BOND
FRAMING/STAIRS/E.EGRESS NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
INSULATION/vENTII ATION 2� (� BUSINESS LICENSES ARE OBTAINED
PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT
EXTERIOR SHEAR/HOLD DOWN �+, `�✓(2 �'' jSSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION.
INTERIOR SHEARMOLD DOWN j'L-i Z 'v J �'' C1 R-0_4 Q e 67 l Z Z/'• �Z-.
W/1}l £XG IMPORTANT
SIIEETROCK/SHEETROCK SHEAR r
EXTERIOR LATH/W-SCREED When a permit has expired,a charge totaling one-half the fees to obtain a new permit
•} .�-,�✓:..� � ,.�� must be paid in order to reactivate the permit.If a permit has been expired for more
ATH` .?`�3 l - than one year,a charge totaling the full fees to obtain a new permit must be paid
r to reactivate the permit. _
SCRATCH COAT r5f I,--Avs Q I� ��vJ''�/� �'�� ! C `(i
c� NOTES: / y�i //
SEWE "ATER�. 6 i f 3 y-.� �-JI,�j,•a/� �`'" 6� `� �Z
T-B CH/ELECT ABOVE CEII �� •vv`'/✓ , Z6��3
ELECTRIC IviETER RELEASE ►l SPECIAL INSPECTIONS Inspector: Date:
GAS TESUMETER RELEASE r "
iOOF INSPECTIONS
l-
GRADE-PUBLIC WORKS INSPECTION:Inspector: Date:
FIFE-CALL(408)378-4010 TEAR-OFF: Inspector: Date:
PLANNING(408)777-3308
43 � PLYWOOD: Inspector: Date:
SANITARY(408)253-7071 " i
BATTENS: Inspector: Date:
ELECTTRICAL
MECHANICAL IN PROGRESS: Inspector: Date:
13 /1-f
PLUMBING ,� � b
FINAL:. Inspector. Date:
HANDICAP ll NOTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION.
OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY
INSPECTOR
BUILDING'
CERTIFICATE OF OCCUPANC ' � �