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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., BUIIDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinqCa�cupertino.orp
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS � APN# 3 59- 3 Z �O�� DA� s,., �3 )� ��
OWNERN E _ ,�_ � PHO�-� _ �� EMAIL I.�n -��n /_ �Ma f.,
�� /G� �J`Go
STREET ADDRES CTTY, STAT ZIP PAX
05 /�".0 9 oZ-�
CONTRACTO NAME � � PHONE &MAIL
G -D — 8$'—Yv
STREETADDRESS Q CIT�HATE,�IP ��v � � FAX
�QQ
MAIL CERTIFICATE TO: Please a11ow u to 10 business da s for delive
CONTACT NAME � pH NE E-MAIL
e 0. -�-� - o.�- qn _tt�lco��a,'/.
STREET ADDRES_S �D CITY,STATE,ZIP/� ZZ_ FAX
i o'�-�
��.se c�l� t•�1,�n �L r3 r�: � w://p,� � �cJ,�• c�.2y o�i� .
LI T A L BUILDIN ERMITS ISSUED FOR PROJECT:
PERMTf SUBMTi' ISSUE DATE INSPECTOR SCOPE
NUMBER DATE DATE FINALED
1 3 a�o� � �
a
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1
2
3
4
BUILDING DATA:
#STORIES i�STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRINKLERS
BELOW GRADE ABOVE GRADE FLOOR AREA LOAD RE UIItED ES OR NO PROVIDED ES OR NO
t#PARHING #STANDARD/COMPACT #ACCESSIBLE
RE UIRED PARHING PROVLDED PARHING 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 OS/07/12
; . CITY OF CLfPERTINO BIIILII�II�1�PE��I T INSPFC�ION CARD
�BUILDING ADD�RESS:'7558 TIPTOE LN CON'TRACTOR:3ESTPUILD P�RI►sI'r 1vo: 13080209
! O1vSTRUCTIO�INC
3 OWNER'S NAME;YANG CHIANG-YUAN AND TE- 1732 143RD AVE nA'rE�ssuEn: 12/05/2013
�3'UAN
ov►'NER'S PHUNE:6509418608 SAN LEANDRO,CA 94578 PxoNE 1v0: (510)388-5099
ti�sr f-` � r.` �"
�FOiJ1vLATIOIvir�RSlFi.u.S � (�t.' a,�j BUILDING PER'1�lIT INFO: BLDG ELECT PLUMB MECH
UFER GROUND � � g��ENTIAL� COMMERCIAL�
PAD/SET BACK-CERT .IOS DESCRIPTION: CONSTRUCT 1 STORY SFDWL TO INCLUDE 23 81
�r�U ` L FT oF
GARAGE SLABS/PREGUNTTE ^/��,t�I, Q _
r � 'G
PU
uND£RGROUND/SLna LIVING SPACE, ATTACHED GARAGE 430 SQ FT, AND.
UNDERGROUND PLLTMBING
POR:CH 28 SQ FT
UNDERGROUND.ELECTRICAL : -
Uh7tLRFLOOli°Ll1MBL`:G �� ` ,.A J .
6 N..
UNDERFt;00R MECHAAIICAL
lJNDERFLUOR ELF.CTRICAL
WILDLAND URBAN INTERFACE FIRE AREA r ER#
UNDERFL.00R FRAMII�IG VENTS (,� TO ARRANGE INSPECTION .
�UNDERf'LOOR INSULATION o,. ,. S"' Call�77-3228 between 7:30 am and 3:30 pm Monday through Friday,at least 24 hours
��
�.�,�° _��r�� ,� ,gp,�, before required inspection.Job address and Permit Numbers are needed when
xc�oF sttE.al�turr� �7_ requesting an inspection.
RUUGH PLLJI�IBING� � �-i � „�,,� CUPERTINO SANITARY DISTRICT
TLBS&SHUWER PAN Q` Closed circuit video inspection of property line e�eanout,poinc of conns:ction
� and street lateral re uired rior to assin FINAL CITY PI.UNiBING
Rcvcx n�cxnhica.�, 9 P P g
�� �-. INSPECTION. Call the District(�08-253-70'71)for an appointment.
IZOUGH ELECTRFCAL./FOOL BOND � 1�/ ��
.,�
=���i�T�s�.�� � � r1t,.� ��^' NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
11QSULATIONiVEN:Q.AT10N _ � BUSINESS LICENSES ARE OBTAINED
�'�-�-F � � � ` PERMIT E_XPIRES IF WORK IS NOT STARTED WITHIN 180 BAYS OF PERIvIIT'
Exrr:iuox st-�nwxoL�Dowrr �_ G., ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECT70N.
�rrriuox sr�wx�ioLv Dowrr ��� `Z
SHEEIROCKISHEE:'R�CKSHE C^1 -'? � IMPORTANT
� ' When a permit lias expired,a charge totaling one-half the fees to obtain a new p�r�nit
FxzEiuoR taTt-uw-scREEn e �, ,r�rE1 must be paid in order to reactivate the permit.If a permit has been exFired for mure �
1NTERIOR LATH .� � than one year,a charge totaling the full fees to obtain a new permit must be paid
��� _ � - to reactivate the permit.
SCRAtCH COAT � '}�„/� �r CO p C�.Z
G s �` �1« 5J
s�wEivwnr�tt NO E.: t
����ly - Vr,�ri�'� G�IVJ�B� � `��c���F �
fl T-BAR/MECH/ELEGT ABOVE CEb '��. y�„_W�✓�'`'
�F.3l�A�"`"� x e�. .: °f�IJGF`+ �C.�t' �}e���GF$
`E�'�,�'`�'��t��..�?E�t�`s`'S¢ j =/�•/ SPECIAL�1�SPECTIONS Inspector: Date:
�uAS'CEST/ME7 ER RELEASE /d�'?'1 R„9 j �
� � � ROOF INSPECTIONS
�GR.4D�—YUSLIC W OItKS y �Z. �� -INSPECTION:Inspector: Date:
FI3tE-CALL(408)378-40(0
j� �, � � TEAR-OFF: lnspector. Date: ,
PLAI IMNG(408)777-3308
_ -------n—�-�
PLYWOOD: I�spector:_ Date:
SANITARY(q08)253-7�7! p
___.. _, ( BAT"fENS: inspector. Date: T~
£LECTTRICAL I_� -^� .
I -- - 1 � IN PROGRESS: L�spec:or: Date:
MECHA�II�AL !--. , t`-_ r ,
1 . l C3
PLUMBING �AL: lnspector. Date:
— �- 'i
HANDICAP NOTE:OSHA APPROVED AGCESS TO ROOF SHALL BE PROVIDED FOR iNSPECTION.
ENERGY �^ � � 1- *OCCUPANCY OR BUILDING NOT PERMTTTED UNfIL BUILDING FINAL IS SIGNED BY
''� INSPE 3'OR
�UfLDTNCr �-� `���� �. //��� ���� � � � �
� '�--
�CERTIF[C.4TL OF OCCUPANCY• � �
� - -
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