15050182 - COFOa Building Code certifying that
d for compliance with the
,nstruction for the occupancy
is classified.
Issuance Date(s): 08-27-2015
: Throughout
NOTICE/POSTING: No,changes shall be made in"the chara6ter2of occupancy °Ti�sncertificate shall be postedlina conspicuous place on
:the premises, and shall not " re►noved except by the authority: of thiiBuilding %
CUPERTINO
APPLICATION FOR CERTIFICATE OF OCCUPANCY
OR CERTIFICATE OF COMPLETION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 • building cupertino.org w
COMPLETE A SEPARATE APPLICATION FOR EACH RITIT.DINr-
PROJECT ADD S`•1 '7 1 MVIN S UR IS P 316 2.0095 - 194IS
v 1 IE
DATE Lf I
ANNERNA314E �NSTKC-fit' CU��nNo AGG.
P1i 0t �7 3DO)
-MAIL `` MAU
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STREET ADDRESS 1 5ba Vf � o PMKW�(
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CITY, STT �w'O C� aC O'L4
1JG.�I��-"u0t3@0ftmK,,0p
""(108) 725 03�
CONTRACTORNAPoIf %�/�WS
1COM11;i =0t4
PHON(530 &qZ 8H58
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STREET AD V W j ^ - r
err 1..f7�r`'" " (L.L' CQ, 15(#6.
PA SS64twftll
"L CERTIFICATE TO: Please allow Lip to 10 business days for delivery):
CONTACT NAME^^nQ 7ftcp PHONEN' Q'Sq-;5153 E-�AI�i�wrm9CgQeHu.•�-'wCR�ae-
STREETADDRESS' v M ir4O/` SMA Sr CITY, STATE, ZIP /^ /�-J �Jay�i�7` " TAX VG CWl7 �C
LIST ALL BUILDING PERMITS ISSI IF.D FOR PRO_TF.('T-
PERi4IIT SUBMIT
NUMBER DATE
ISSUE DATE INSPECTOR SCOPE
DATE FINALED
--f
1 15050182 512.9
912. 12 3 / e014.0 00r SNGU /N 7a COFFEE JjW
2
FIRE SPRINKLERS
PROVIDED YES OR NO
3
1 1
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1 v%trQ 2 q2
2 PV 1 a e R 412
3 .tx t yy
4
BUILDING DATA:
#STORIES
BELOW GRADE
# STORIES
ABOVE GRADE
OVERALL
FLOOR AREA
MAX OCCUPANT
LOAD
FIRE SPRINKLERS
REQUIRED YES OR NOI
FIRE SPRINKLERS
PROVIDED YES OR NO
0
1 1
IS10/8' SP
I T
I 'Yes
# PARKING
REQUIRED
# STANDARD/COhIPACT
PARKING PROVIDED
# ACCESSIBLE
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:
CoJO Applicatioadoc revised 05107112
AaAk
;Ie vv\
CITY OF CUPERTINO BUILDING PERMIT INSPECTION CARD
BUILDING ADDRESS: 19439 STEVENS CREEL{ BLVt3' CONTRAcam: OAKSTONE �r PERmiTNO: 15050282
oNSTRvCTlorr INC
OWNER'S NAME: MAIN STREET CUPERTINO 1065 YOSEMITE PLT T DATE, IssUED: 08/27/2015
s ,s PiroNL : 5083602650 PLACERVILLE, CA 95667 � PRONENO: (530)642-8858
FOUNDATIONTIERSM.D.S.r" ' BUILDING PERMIT INFO- BLDG ELECT PLUMB M,CH
UFER GROUNDRESIDENTIAL� . COMMIIRCIAL
PAD/SHTBACK-CERT JOBDESCRIPTION: PHILZ COFFEE - T.I.MAIN STREET (PAD 1) TO BUIL5
VYJT SHELL 2,121 S.F.
BOND
INTERIOR
WILDLAND URAAN INTERFACE FIRE AREA ERN
TO ARRANGE INSPECTION
Cali 777-3228 between 7:30 am and 3:30 pm Monday -through Friday, at least 24 Fours
before required inspection. Job address and Permit Numbers arc needed when
reiluesting an Inspection.
CUPERTINO SANITARY DISTRICT
Closed circuit video inspection -of property line cleanout, point of connection
and street lateral required prior to passing FINAL CITY PLUMBING
INSPECTION. Call the District (408-253-7071) for an appointment.
NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUTRED
BUSINESS LICENSES ARE OBTAINED
PERMIT EXPIRES IF WORT{ IS NOT STARTIuD WITHIN .180 DAYS OF PERMIT
ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION.
r-4,,,, IMPORTANT
When a permit has expired, a charge totaling one-half the fees to obtain a new permit
must he paid in order to reactivate fhe permit. If a permit has been expired for more
than one year, a charge totaling the full fees to obtain a now permit must he pair!
f J to reactivate the perrmit.
=2 I
NOTES: �r�t f "'i � JL4 /j")�71V � � +�•- . f-Cy�'�� ,/�'';.C� f. ''�'�
SPECIAL INSPECTIONS Inspector: __. Date:
ROOF INSPECTIONS
PRE -INSPECTION: Inspector: _
_ Dale:
WAR-OrP: Inspector:_
Date:___
PLYWOOD: inspector:
_ Date:
VVITEtNS: 10pectar:
_ Date;.--
ata;._IN
INPROGRESS: Inspotor:, _'.
_ Date: L_
FINAL: Inspector:_ _
Date:___
HANDICAP -� - — ,d07L; OSHA APPROVED ACCESS To ROOF SHALL JIB PROVEDED FOR ICSVECTION
OCCUPANCY OI+BUI..LYj-iNG NO'F 1'FRMITTI+.D UNTIL BUILDItIG FINALIS SIGNED BY