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' � �.-�.., � � � � °�Q U d O �- � Q � v ! i - U � •� � � .fl- (n � o c c � � (U � F' i � tA � v � � ' � O � "� tL6 � L � ca c6 W � Z � � � H � �0 Q � � U' H U U LL lL � Q i � � �, 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• buildinaCa�cupertino.orq COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING: PROJECT ADDRESS �`�� �� APV n D,�TE �/ � % OIVNER NAME PHO\B p��,.,� E-bLA L � G�G , � — `�CJ� �1�C�1G .� Li� � ��l Y OG� C�--�.„ STREET ADDRESS CITY STATE,ZIP FAX � /v/ 2 Z �3 � � ci-z.�t�� - ��-{-��t�Lv ��y°C`� � CONTRACI'OR NAbtE PHODIE E-�1AIL STREET ADDRESS CITI', SI'ATE,ZIP FAX MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery): CO\TACTNrL�1E �� A I-IS� rl_���-�� E-MAIL — ._��� ��a L, � C� •� � �'��1 STREET ADDRESS C[TY, STATE,ZIP FAX � 3 b Ov�7_ �o�-�-�� ` � -�c C� � � LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: PERNIIT SUBM[T ISSUE DATE INSPECTOR SCOPE NUNIBER DATE DATE FINALED 1 I � I I D ZlZ ( - � � ` c�,�--� 2 3 OCCUPANCY DATA: USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD 1 i C�� ' � ��J Z S 2 3 4 BUILDING DATA: #STORIES #STORIES OV�RALL MAX OCCUPANT F[RE SPRINKLERS FIR�SPRINKLERS BGLO�V GRAD� ABOVG GRADG FLOOR AREA LOAD REQUIR�D (YES OR NO) PROVIDED (YES OR NO) �" 2 S #PARKING #STANDARD/CONIPACT #ACCESSIBLE REQUIRED PARHING PROVID�ll PARKING PROVIDED NOTF: 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)? Perniit Sig�ed ott in system? No other pennits open or expued in system? Location of Approved Otlice Set? CofO Applicntion.doc revised OS/17/16 �--------- CI'lYOFC'.;PERTL10BL1II.DL�GPFRMfI'�SPFY"ITONCARD f-------- -- - �E(JPLDL^1GADDRESS ��" ;� } iPIIiMCCNO �10334 S TA?�'T.4L AVE ICO1V17LACT(1R r� ` � �„(�:; �'`� f �t,j;, ,�., "� �F %„� � (C[,�ER'I'�JO,CA 950143544 i - �I15110172 OVVN�2'SNAME -i — PIItM[T'LSSLJ�D: 10334 S TA1v rAL'A VE CUPII2TTN0,CA 95014 �ILI ANSHAN Ei'AL 02�2?J2016 rV4fi'II2'S PHGNE � i------ — PHONENO: JOB DFSCRiPT'10?�: �CONSTRUCT"I�NO STORY RESiLE'10E(3727 SQ F1�;GARA�(489 SQ FI`);COVII2ID PORQ-I(616 SQ FI'). (SUI�'NYVALE SANPTARI� TI'PE IIVSPECTOR DATE . PLIPI7BLVG �` �� I _ � J ) �� � � '' � � �{. �LI�FRQ20UND GAS PTPING !t� ~� � ' I � /. :LIR'Dc.2GROli'�WATER P�-��Y `��"'�f�.,•�� �: . a< �ERQROU*IDSL-tiVER �`�`7�f�,,..,- P"`,� '` �`"�' ^-� I�,,���z ;;;r� � �-�,�--(�, � , �iROUGH PLUIofEA�G �sxowwmr.a� `;� i_',� �,�'tI�`��, :R�A7�FIEA';'ER (WA7'ER SIItVICE - - (_G�.ASPRrcSLRE7'FST � �� I f7`�`i � �: iIGAS M`nl't�t RFLEASE +r`-'..�(�.{�., �"�,S�� I I�---- 4 t (�PROPERTY C.L\'E CLLANOLT �-_� I I �PLUMSBL^G FLti4L i � BLEC'IRICAL ;U`.'�— TOARRyNGELNSPDC'I'[ON ��-�— Cali 7',7-3228 beri�een 7:30 am and 3:30 pm i�lonrhy through F7iday,at least 24 hours nefcre rc�ui�ed i Uv�ER:�.'20UI�D �L— inspecfion.Sob ackhess andPermit Nurnbers are needed�rhen reques6ng an inspecGon. �IUNDERFLOOR �� li---- --- — C[JPII2TLti0 SA.\TI'ARYDISTRICT �'ROUc�[C.F�'I1tICAL _� Ciosed circuit�ideo inspection of proper:y line cleanout,point of connectioa �� � andstreetlateral re red ior to sin FL1AL CI"CYPLiJ�1BI�G �TE'.vfPORARY POW"rR POLE � Pr Paz g . INSPECTION.Call the District(408-253-7071)for an appoinhnent i iSER��7CE LTGRADti � ^ �� ,.,—,��. ''� ' NO BUII.DLNG F�AIS INSPDLTI0IS U�"TII,ALL REQLIRID � �EL}iC7 RIC METER RII.EASE �Il,+��"-H--�_,:1��-- ��� �•.7 l�� f" r b����.,'-=.i BLSL'�'FSS LICE\SFS AREOBT.AIl�'ID �ELECTAIr FfNAt. � � i�¢��;�Z�, PFR:IIlTA'PII2FB IFR'ORKIS NOTSTARTID WITHIN 180 DAYS OFPIIL�T[T �` ---- �. � f ISSUANCEOR180 DAYS FROMLASTCr17.i.ID L�SPECI'[O�v, i �I.J!�DF.2ctCX_;k �r� le.��s �j 1 I� r:, �S i ( �-------- }�---�'--- 2oUc:����!cHA;tcn_ I II��ORTAIVT When a permit has espired,a charge totaling one-half the fees to ot�eain a nesapernut �-��"-�------ must be paidin order to reacb�ate the permit If a permit has been ez�ared for more �IgUR\n*1CF ,L____._�___-.�.__ than oae year,a charge totaliug the full fees to ohtain a newpernut must l�p�aid �nl�Ce'W71T?u�TM�ft to reacti�ate the perrmt I!---------- ----�- it:rUO'J:; �.. j------- � �114�C"fL1T�;C..;F1Tv.L ���T�S � I " � (i�. � _ T-IiAR _ - �'.. ry T � ;� �('�� �.� ;--�`i �. � i�r*u"Bu:G'---- -- � {�.�_. (t ��1�"�7!"'' �! l,,f�j� � j`�.���� ,^�;., [,^�!`�`�, ,, 't�,l'i,�j \ t`� � � /� � k ��.�/', ; , f , \✓ ����� 1��.�CTTC�. � V L s-__ / � P I,��r,_n�rc,v. �-- �--- �._ rI � ( `1 f t. sr-? �.. . ._"!•�. f i�[LDL'vG `---- I i.: 4-�--""-.! {_� �l� "L�1 �� !W �_E �i._ � / I ---------- � �� ' `�;\d ' .:�_`,�: ; r-� � � _� •d � �"�.- ��R� � '� r� 1------ - � ' •} i� � �., ;. SR'L�t�11LNGPOOL / � f" (�`' r ` �i"F'JtONr£'�iFVT —� i �< r"t C_. �� .� �.�.�`--�..a.�.�`.1;r�e'i,� .� � j �_� °/ 't� •r `� t, �I------- : ,�J iiP;?�i�E. I � -'------'-- �F.'SCi F_IC,SI.AO��DP�'G � � ' R�OFL�G —��r_ � i�._ :.� .�__�,_ ;PItI'.IIJSPFt:T:ON ---� � I �TEAR OFh'�--- --- � '-' T �NAII_fNG -- � 'BATTE\5 _ — --� 1._- '-' �.� 'S1TE -_�—Q�SPECTOR DATE II-v TPPF � L\SPECTOR DATE TYPE INSPEGTOR DATE � 'OTJ�A'fIJN fII�-- Y�,'.IB'*'G i I �A�1'ARYII�SPECITO\S '- IX��,L\„S � ���}"� �; �- �f+�. '�SI30R'L�Y ti\ f��`i 7 1,.� .• ,.,t��. �L:�ULSc�2�JND I�- ,� � ,. _ � � �_ IiU}'ETt f�-r������,�` R'ATER HEATrSt I-P,�DROFLL'SH I: � ____. � ��PIItS� ..����,�t , .. i�� WATER SE.RV�ICE � � IGR4DEBFAMS __ � � GASTEST � PUSLICR'DRKS � GARAGE 5 �``/ J� i•--1 I�; �,`�1'�-�� GAS MLTfRRII.EASE ( �RIQ�['OF WAY �'`�„ia E � . I� GROL'nD/S E R'ORK - . — i --��GRP.DI.NG � ��,�,,,� � / . `�. LRvDERCiltOU�iD ELECCRICAL Fi.&CTRICAL ' iRET�ALL 1 r�J!� � UNDERGROLJ.'�D GAS PII'ING �TF1�6'PG\1'E2 POI.E �-�--�--� I � IIL.'�D' ERGROiJ.��R'ATER �SERVICG LPGRADE FTRE DEYARTTSE:\T �- �FRGROLJt3D SE�1'ER �— PV SYS'IE�1 STTE CO?vtPLL1.*10E �S�T'F WAIS�S FIRE MAIN SYSTE�IS �EV SYSTE.Ui iF007�AIG � FDtE SPRINIQ_ERS-ROUGH � F------ i ;�--��-! f �M,�so�v[u�nR � ng.ci���c,u, 'Ftae s� pa�aa.sa-F��[ `�,t,�- "2. G.'3 t i I�D A GE FUR1.AhCE iFIItEALARMFInAI. � ICMU A'AI.IS I BOII.ER �STANDPIPE SYSTF�vIS � UPIDERFLOOR � p��Q,,�p�yy� �INGINEIILED FIF2E PRlYI'ECTION SYSTEM I�UI�'DEIti�1.00R PLiRviBAG -- .,� L-- - Ii00AS �FIItE LSFE SAFEI'Y �„��� I�LJNDERFLOOR!v1ECHAt�'ICAL ' � •, I i D�„� I ��---- �un:�exFr.o���cT�ucn[. i voc�m�,nTaTtoN j------ - �UNDFRFI,OOYFk4�fL*1G_ �) I ' � � l ` T-BAR �PAD,'SETBACKCERTIFYCATION � ,,. � �:�,�..�.� r--- �~ �� � -_�--= I�U;v�EkFI.C�f.INSI'�_,\'CIO?�—� � '����1� �_, PC.L'�fBI1�G TRUSSES , — . � �' -- —�'= -. — - -- -— -- --- � I' "FRa�\S�G I - �------ ELECTiCAL SPECiAL 1NSPEGTiON REPORTS i��eC.WR\AIL-SF?EA't'h'1\G ����C� SVfOKFJCARBONMO\O5.'IDECERT OF - � CO�IPLIAI.CE I I �FO[`Gi3 PI.LMIDINCi------ -.-y�� ��;..� �� ----- �-= 7 .,• _�I BU[LDING WATER FIXCURE CERT OF COMPLIANCE � II___ •"� s ` ' IIRo�.c,��ucf�,x�ca. _h �- � �- t--- • �----- --'-- ,..g I ---��F� IEtJERG� YCOVIPLIAhCcFOR?VtS � `` �� 1 �(/ R�Jl'G[i ELEC`R1CAi. -� ! � ���� ` ��I 'f f ICnLGREE;�MA.*IDATORY TTE�fS CHECKLIST r— � ROL'GH PRAMGJG }}�� /� l��' � ,l` `> ;� __� fL=< r�f ' SR'AfI11II�GPOOL r �—�— 1 ,,�__' _� �.�G= r . . F� f' 1 1. i .. �,�+`k.. P.�. �'�+ /� � I �� II;�,�I'RiOR SHFA,R RESI.'FORCIIvfE.�ll' _�..:�� ..� � � .,. �.. _� ��,I �/ i � ---`1.% Ir / ,{ DEPARTi1�NT F71\4LS � I�XTERIOR SF�E.A�'�� "'�.--�.Q�-}��f , (`} P/M/E �PLn1�NLtiG-CAL.L 777-3308 � � r,� f;�'� I1�----� I��'�'A I L l I S S 1 1 L A T I O N E L E C T R I C A L B O N D A G I � : "'`t _� i IPUBllC NORKS-CA._I.777-3354 (i ? � ����-�g l l�..� I--- � d � �' . .(.IIiitiG i�'SU7_4'i IO'v ���� DEMOLITION � ��� �I` FIRL-CALI.378�.010 � ��` � _.-----=�. ---�. I'ROOF i�P.d.L\ �' �l, �.-� . �.I-��: HACKFII.L i � ��I �'� ���l � I IFALT H-CALL 408-918-3400 L_ ;r . �:\TEIilORFT,�SH"'r,S . � ---- ISANITARY-CALL 253-7071 I �fSf�TR(xK --- �� . ROOFIIVG I-- -'---� !'- ;IT r'_6 BACI�R UdUIItL.AYM1fQ�T� PRE AISPECI'IO\ � --:---- r,--- _ � BUILDING FL\ALS '-- 'i7'Il.L:BAC1�R I TEAR OFF iPLU':v(BIIdG - � i - �:II�'iFdZ10R;.ATF: NAII.AG BLECTRICAL � '°� a� � i I���v EXTF.}L'ORFI:�ISHES BATTE�'S i , J � r ,� .,f Iii�\Tr.270F L4TH�-- � ,�� MECHA\7CAL � �� r �I_------ ---- � TEMPORARY OCC�JPA!JC2' � ' S�.1 A]CH COA7 r - �-{ � — — ir ; t�. ?".� � � I� - �• _,:� � r �BLJGJDLNC .? � �s I� fLl.--- �---� � �i � — —� L==`==-'___-_---__ ' i � ��, l\; f ;i ', "'{ � �'` � �� �>,, .;�,� ,,.—� j-- i_ r `i! :� �'� � f � � � �� _, z �f l � i��'��m�. ,,.� 7�"t--� �'� ' ;` t / , i ��-�� , �� , , �.�`' ,7• ' ' : �i ,�;_. t r � ;� �, t, �f .^,. ',� f. � �, �`� ,�.`; ("-f f1 �j ���'�,,,� ._�-, '�r�,r ` " � _� if \ � . �`s ��----I-�� `—�`� Ff �--_ .�l � ^i/� I -�' � _ � --� - �._ �r'� � `� �.'� ��� � � ��'t.��<:J�L) r_1�.. i A,� ��` �,� �� �•, ! �� !,� -'r� �;f�� r i+',-�(� �� �� ['`r�. ..:!.;*�,.. �_y f,�, �7, '��! .1 i l.• ��_t-Cy I l.,!f/t✓�,' ��- f`�„�./�`�. �+`�'`,.�'p�(,��� � f f . _ _, - ` ,,.:,