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CofO Application.doc revised 05/17/16
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS APN # DATE
OWNER NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP FAX
CONTRACTOR NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP FAX
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACT NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP FAX
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT
NUMBER
SUBMIT
DATE
ISSUE
DATE
DATE
FINALED
INSPECTOR SCOPE
1
2
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1
2
3
4
BUILDING DATA:
# STORIES
BELOW GRADE
# STORIES
ABOVE GRADE
OVERALL
FLOOR AREA
MAX OCCUPANT
LOAD
FIRE SPRINKLERS
REQUIRED (YES OR NO)
FIRE SPRINKLERS
PROVIDED (YES OR NO)
# PARKING
REQUIRED
# STANDARD/COMPACT
PARKING PROVIDED
# ACCESSIBLE
PARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED
INSPECTION CARD TO THIS APPLICATION.
- OFFICE USE ONLY -
SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST:
Copy of Job Card Attached (both sides)? ________
Permit Signed off in system? ________
No other permits open or expired in system? ________
Location of Approved Office Set? __________________
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
19960 Stevens Creek Blvd 369-05-008 2/15/17
Eric Hoffman Fmly LTD PTSP
900 S Winchester Blve STE 7 San Jose, CA
Swinerton Builders 408-334-7270 hyoung@swinerton.com
280 Townsend St San Francisco, CA 94107
Hannah Young 408-334-7270
2880 Lakeside Dr STE 300
hyoung@swinerton.com
Santa Clara, CA 95054
B-2016-2762 9/19/16 10/12/2016 2/14/2017 BG 1st floor; T.I. (3322 S.F.) - First Federal Credit Union
Bank Bank V-B 3322 S.F. 20 Persons
0 1 3322 S.F. NO NO