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APPLICATION FOR CERTIFICATE OF OCCUPA CY
OR CERTIFICATE OF COMPLETION �
,
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPEit71Na ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL I
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildinqCa)cupertino.org I!I
i
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS �O� � � ��.Tn��.� APN# DATE �II,� ��n I�' • .
�'r 5/
� OWNERNAME I��J�,.`L: � � � Y�'��,�l�1Cit L� PHONE /_ U l�� .�tE°,. �E-MAIL I�'�I I�.J-��1���(�-ii l-F-l.•1.��7
�.��
STREET ADDRESS I D lY�O S���p'(`�-� � '��� � CTTY, STATE,ZIP � FAX .
Lvl`��'�7�-SO Cf4 SSO�i��
� COIdTRACTOR NAME - � � � �. � � PHONE � �MAIL I � .
CUv:,�r_ (' � Lt> `�r2
� STREET ADDRESS � � CITY, STATE,ZIP FAX� � � �
�43 C��/L ,
MAIL CERTIFICATE TO: Please allow u to 10 business da s for delive •��-��-�— :.-L u� ��" f DS�.� ��[6
. - CONTACTNAME, .f,'7/;���'�-l �. ... Y 1�. . ' �� � PHONE�SU l Z� _..�(j T E-MAII, !�J��'L� V-
1�� P �,
STREET ADDRESS� � � � � � �. '� � CTTY, STATE,ZIP � FAX C „�)
�`BO�L � �,�ri�-
W�`'Q�
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: i �-�
. PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE
NUMBER DATE DATE FINALED
1 � � ` � � i Z � r.��
2
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR ARE OC UPANT LOAD
1 Z ' a"r- t�ts��t7^�tG 0 SCa =i
2
3 �!
4 �Q
BUILDING DATA: � ���` ����
#STORIES #STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRINKLERS
BELOW GRADE ABOVE GRADE FLOOR AREA LOAD RE UIRED YES OR NO PROVIDED YES OR NO
�� - ✓�
#PARHING #STANDARD/COMPACT #ACCESSIBLE
RE UIItED PARHING PROVIDED PARHING PROVIDED NOTE: ATTACH�COPY OF THE SIGNED
INSPECTION CARIP TO THIS APPLICATION.
- OFFICE USE ONLY(To be completed by inspector of record)-
SPECIAL STIPULATIONS OR'CONDITIONS: '
,
,
CofOl Application.doc revised OS/07/12
.
CITY OF CUPERTINO BUILDING PERMIT INSPFC�I'IO�T CAitD
iBUILDINGADDRESS:10610 S TANTAU AVE CC�N�TRACTOR:TAF�YO CONSTRUCTION PER. iTN0:12020111 r
� C� i
;OWNER'SNAME:PRIGGE ROBERT E AND MASAMI ` OOMONTEBELLOAVE37 DATE,IS5UED:08/22/2012
' OwNER'S PHONE:�082032515 MOLJ?vTAIN VIEW,CA 94043 PHOWE NO: (650)796-1790
�i3SP =.,•:°_. . r.,�: �. .`� _. .�$�"E�n.�.:,r� . � ? 5 C�R
FovrmnTiorriP�RS�.D.s. � _ .. BUILDING PERMIT INFO: BLDG� ELE�T� PLUMB� PvIECH�
UFER GROUND � �
�— " a-- RESIDENTIAL" I COMMERCIAL'
PAD/SETBACK-CERT � � � JOB DESCRIPTION: NEW 2 STORY HOUSE 3,040 SQ FT (INCL PORCH &
PATIO), ATTACHED TWO CAR GARAGE 440 SQ FT
GARAGESLABS/PREGUNITE (3480SQFT) . (SWIMMING POOL & PHOTOVOLTAIC
�RL1R.�1Q:�C3�T,, zl�Q a�:�IA�:. �i�, � �:�a�'
UNDERGROUND/SLAB
UNDERGBDUND PLUMBING �
lJNDERCROUND ELECTS',ICAL
�IJ�' i'�'().�S��s��%0.:.. � 1�.r1 ,���"�is�'-' �E:: I��E!.
L'idDERFLOOR PLUMBING ' ( _ I_ )
v
IJNDERFLOOR Iv;ECHANICAL
UNDERFLOOR ELECTRICAL
WILDLAND URBAN INTERFACE FIRE ARE�►� ER#
_..
��rmE�LOOx Fxn�rG vErrTS .. _ � ��yy� TO ARRANGE IN5PECTION
�,n.r�Er.Fioolt n�rsut,nTioN � Call 777-3228 between 7:30 am and 3:30 pm M�onday through Friday,at least 24 hours
,g������;����� _ � �����, ��� �- • �- f before required inspection.Job address an�l Permit Numbers are needed when
ROOF SHEATHING requesting an in�spection.
ItOUGH PLUMBING �
" CUPERTINO SANITA4RY DISTRICT
TvBS&sxov,��PnN Closed circuit video inspection of property line cleanout,point of connection
^( �^ 3 � and street lateral required prior to pas�ing FINAL CITY PLUMBING
ROUGH MECHANICAL ,.._
° �� INSPECTION. Call the District(408-253-7071)for an appointment.
ROUGH ELECTRICAL/POOL BOND ; „ 3
F�utvmaGisl'n�zs�.EG�s , �c .. ' NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
irrsui.nTioN/.�E:VTiiaT.oN BUSINESS LICENSES t�1RE OBTAINED
�-'� --�.� �
��a ������� � ��_ ��������� �°' ��� � � � ''= _� ° `'� pERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT
Exr��iox sf►aa�oLD nowr� _ � 3 ISSUANCE OR 180 DAYS FROM L�1ST CALLED INSPECTLON.
INTERICR SHEAR/I�OLD DOWN
� ShEETROCKiSHEETROCK SHEAR IMPORTAiNT
'' �^ �_ 3 � - When a permit has expired,a charge totaling one_�_half the fees to obtain a new permit mu
��FXtF,RiUR LATH/W-SCREED
� � ` � �j �j be paid in order to reactivate the permit.If a permit has been expired for more
� tNTERioR r.qTH � � �� � than one year,a charge totaling the full fees to obtain a new permit must be paid
�VO�,z���UR T�L�i��1�1�N����, �45�¢ �' 1G�I��P£��, , �� �to re ctivate thc permit. �
� �CRATCH COA (� r-'3 � �r �— 3 7r V� �' ��p I � o K
-, � a- � v
�... Tf S: •
�e��ww.4TEa �� � ����� � �
( �.,
T-BA32/MECtT/ELLI.T ABOVb CEIL �
�F.II�jALS, ,� � .�;��s..�,�;�� „.. ..��� ���. ��:� �.��.'��.�` �,a;..� � ������ ��[( �.l�
�. ._
EL�CTRIC I��T�R R�LEP.SE
� , ; - � , SPECIAL WSPECTIONS Inspector: Date:
GAS�TEST/IvIETER RELEASE � �' '3 `'
�� � ` . ROOF INSPECTIONS
i;RADE-PUBLIC WORKS ! ''. PRE-INSPECTION:Inspector: Date:
� ` � �,��. �—
�FIRE-CALL(40S)?78-4010 � .� j TEAR-OFF: Insnector: Date:
PLANNING(40S)'17�-3308 �� � pLYWOOD: Inspector: I Date:
��. _
Po SANITARY(408)253-7071
' BATTENS: Inspector: Date:
�LECTTRICAL ( � 1�
�- - IN PROGRESS: Inspector: ' Date:
�P:itiCHANICAI ,
i � � FINAL: Inspector: Date:
aYLUM�:.N,r_, � ZL l
�i ...__... . �
�T�ANnlCaP NOTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION.
�ENEF�GY *OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY
� - `( SPEC_TOR
��L'L'ILL'1NG ' �iZ ��1
,� _ # !,z 1 t�C�}�`���. �� c��c��`(��/� t a��l—�3 �TSI�
�c'�2TIFICATE OF OCCUPANCY +
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