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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., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333• buildinq(a�cupertino.orq
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ry Dj2ESS 9. ) 1 �`+m APN= ���_ l� � �`� i D.ATE �La �/� i/� •�
� L � I �
OWNER NAh4E PHONE i� E-b1AIL.
� iI� � ' �T L. ' � f��NGrC�,? N ��fo� c��%?-l{�a as�t�c�,�i i��v1 �' �- rti��,� . v��
STREET ADD ESS �( CITY, STATE,ZIP '� FAX
1� �� .J �'� �c`1'1 ��- '� L�v1�-e�c.- ✓l C� �-� �S'`� "
CONTRACTOR NAME PHONE E-�IAIL:
�{0�'C��.� l�Gt Ut�� �„-z — �bS- G�����«����� c i o c���r�v , c�,,�
STREET ADDRESS CITY, STATE,ZIP �`— FAX
� �� ��� ` �`cC 9 �� � �S �
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACTK�AA9E Ul�l.- l�� l.='�tL��� PHONE/�,���� �E�(�"-,�Z(t_� .E-�fA1L� j�G� (.'- �"� �VC.�'. �� ,
l� � � G
STREET ADDRES 'l i P CITY, STATE,ZIP . --� r' ,�1
'.� � v �1�3C')� � � < �C}'�.l�I �(,�3�-�. � �,h- . (FAY -D� ����— ��v
a
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
P�RMIT SUBbIIT ISSUE DATE INSPECTOR SCOPE
NUNIBER DATE DATE FINALED
1 _ZU��- �a� ���li� - G�i ��� r�.��'
2
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1
2
3
4
BUILDING DATA:
#STORIES #STORI�S OVERALL MAa OCCUPANT PIRE SPRINKL�RS FIRE SPRINKLERS
BGLO�Y GRADE ABOV�GRAD� FLOOR AREA LOAD REQUIR�ll (YES OR NO) PROVIDED (YES OR NO)
#PARKING #STANDARD/COMPACT #ACCESSIBLC
R�QUIRED PAI2KING PROVIDED PARKING PROVID�D 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)?
Pcimit Signed off in system?
No other pennits open or expired in system?
Location of Approved 08ice Set?
CofO Applicntiori.doc revised OJ/17/16
CPIY OF CGTFI21'INO BL7LBING PII2MIT'INSP1�lCTION CARD
BUII.DINGADDRFSS ---T-------
10584 JOHNSON AVE CO1V'IRA("fOR pg�q7�np
CUPIIZTINO,CA 95014-3816 70SHUA CONSTRiJCTION&RIMODFIINGINC B-201Cr1838
OWNII2'S NAME
HiJ HONGQI Ei'AL 16230 A7Ai Fa WAYLOS GATOS,CA 95032-362.% �'�1�6 SL1ID:
OWNII2'S PHONE PHONENO:
JOB DFSCRIPTION:
NEW 2 STORY SFD 1984 SQ FT;NE,W GARAC£428 SQ FT;PATIO/DECK 466 SQ FT
TYPE INSPECTOR DATE
PLL'MBTNG
UNDEft(�tOUND GAS PIPING
1.JNDERQiOUND WATII2 `'t,�� � /�.'`��.J � . . � "'�
LP.VDERQ20UNDSEWER � s-;��1 '+ l-��,�,�f/1^ p�/�� �� ,� ._ �,�GfJTj� (�
UNDERFLOOR .., J `` t �'1� �
IROLY�I PLU,MBING
SHOWIIt PAN
WATER HEATER
WATER ShR\�[CE
GAS PRFSSURE TFST
GaS MET�2 RELtiASE
PROPERTY LiNE CLFi1N0[7�
PLLIMBING FINAI,
' ELEC.CRICAL '!
i�� .+'� , / ''� ' TO ARRAN(�INS PDCTION
I���o� Ca11777-3228 between 7:30 am and 3:30�Dlonday through FYiday,at least 24 hours before required
inspection Job ad�ess andPeruat Numbers aze needed�en requesting an inspection.
UIIDII2FIpOti
xouc��cT�c�. ctm�Tnvo saNrrnitYn�s�ucr
Ctosed circuit�ideo inspection of property line cleanout,point of connection
'f EMPORARY POWN12 POLE and s treet lateral required pior to pas sing FINAL CTI1'PLOMBING
5�.�?�[CE uecxnnF. INSPECTION.Call the Dish�ict(408-253-7071)for an apQointrnenL
E[.ECrRICMEIgtu�He�g .,�j ;-', r. ' ' NOBUILDINGFINALSINSPDCITONSLINTiLALLRDQUII2ID
` ' BLSINFSS LIC�iSES AREOBTAINID
�ELECCRIc FAAI.
MECHnhTCAL PII2MIT FaCPII2ES IF WORKIS NOT STARTFD WII'HIN 180 DAYS OF PIIutiIIT
��ptrl.002 ISSUANCEOR 180 DAYS FROMLAST CALLID INSPDCI'ION.
ROt;'c��n�cxnrltC�a- Il1�PORTANT When a perrrit has ezpred,a charge totaling one-half the fees to obtain a new perrcdt
f.�y� must be paid in order to reactivate the perffit If a per�t has been eapred for more I
- thsn one year,a charge totaling the 1 f to obtain a newper�t must be paid
ant corrorrtot�t to reacdvete the pertst
HO011s
MecauNiCnc.Fu:,ai NOTFS:
T-BAR
PLUMBLNG
ELECLICAL
MECI IAMCAL
BUIi DIIJG
FIRF
SR�4LtiffiVG FOOL
� i RFINFORCFMINI'
�P;M/E
IIJiC7'R1CAL BONDIIVG
ItOOI�M1G
�PR�INSPLCI'ICHV I
�TEAR OFF
NAQ.i[��Ci
BATTII�S
� TYPE �INSPEGTOR��. �- DATE �. TYPE LYSPECTOP.� DAT� .�:�.TYPE � IlVSPECfOR DATE
� FOiINDATION � � �� � .� PLU,'1�BING � . SARTTARY7rSPEC�'fONS
FOO"I'INGS P �` , SHOWP.R PAN �r- �7—I UI�IDIItCdLOLIND
�
UFFR WATER HFATE[t HYDROFLUSH
�p� _ WATER SII?��[CE
(�uDE BEAMS GAS TFST � . ��PUBF.IC WORKS � .
� .
�� RIGffi'OF WAY �,���,'.�:
c�.a�sL,ss = 6 -� cas n�rea x�.�sE `F
�GROU1�/SlY'E- O� QiADAIG �3� /�
UNDFRGROUYD II.EC7'RICAL .�.��F,I.F.(`Trx7�, �� � REI'AAfA'G WALL
lJI1DFRQ20L'ND GAS PIPMG TIMP POWER POLE
UNDERQtOUNDWATER SERVICEUPGRADE -FiREDEYARTMENC� .
Ut�IDERCil20L1ND SEWF..R PV SYSTIM I SITE COMPLIANCE �
...SITE WAI7S�.,.. FIliE MAIN SYSTEMS
EVSYSTEM
F00'TING FIRE SPRII�IIQ.II25-ROLK'di ~ 3✓t°\ '� ) ��;.
MASO�IItY REBAR ���� FIRE SPRQd[Q.ER-FINAI, � �
t�. > � 3'7
DRAINAGE FURNAhY.'E FII2E AL4RM FAIAL
CMU WAI.IS BOII.ER STANDPIPE SYS'CFMS
-.. UNDERFI"OOR��.- AIIt CONDITIONQt IN(3NEERf�FIRE PRO'IECTION SYSTEM
UNDF32FLCN�RPLLJ;vIDING . .... C� � ,..j� �J � Q i
HOOAS FIILE LIFE SAFEIY �/!�
�U!�'DERI'I.00R YIECIIAMCAL � T�_'1 �"-'"^` �7 �-'''-�
nucT w[znr I
ITR�ERPLOOR HLHCCRICAL . . ... .
_ �bt'tT;NENfATtON
�NDERI'LOOK fR/u " � ` _..�� �� i � .�.$�. � PALVSETBACK CIItTIFICATION - , , �. � . .
_� �
I UNDERFLOOR ASUI.�TION ��-'�� � PLUMBA'G TRUSSFS
FY2AbII1�'G � � ELECI'ICAL SPECIAL INSPECTIONREPORTS �l7��' ��"�''I' .;
F[.00R NAiUSF�nTHING SMOKF/CARBON MONO�DE CQtT OF
----- MECFIAA'ICAL,
ROL�GH PLiMBl`�(i � �`� �'9�'�� COMPLIAhCE
-- BUIIDAIG WATIIt FDSTURF CIItT OF CO�'LIANCE
ROr.i(�I:�iFC:tiA,1:CAI. �,� �a��•
i
I RCW(iEi F.I.EC"CRiCAI, . .s�-5� ���°q FIItE °'� i.C�:r` FNFItGY COMPLIANCE FORMS _
r- a+� y
�RaIGt�FRAMIN �� � CALGREIN titANDATORY ITIMS CHECHI.IST �
,� :� e '��'°I swn�mmvcrooL
iNfERIORSIIEAR �? �,'' � -'3- RE¢QFORC'IIvfII�C .
� � `DEPARTh�TC FIIVALS�
�cr�tox s�a,�.7 �<.� — P� 'd ���� ��
PLANNIN('CALL 777-3308
WALL LYSUL.ATIOV �� � _ � �, ECF.CI'RICAL BOidDING
- PUBLIC WORICS-CAI.L 7�7-3354 �
�CF7I.ING L�'SLTATION s�"���- DFMOLITION FIRE-CAIl,378-4010 ', ,ie�� y I'� f
�ROJFTvVT..ThG u '�' BACI�'IIZ z�eiTH-CALL408-918-3400 —�
� L'�TERIOitFG�iLSHES:.�.
E"'-' .. ... . SAMTARY-CAL.L Z53-7071 �
j�'$HEEf20CK `J t- 1 .�j' 7 ROOFING — -
TI IIF.I�A.CKFR Li�DERI.AYMENC PRE INSPEGTION . ���,�... ... "�.. ����� �I �
�"I(LC RACKER __ TEAR OFE YLU,�iBInG � ' s(S- `���.�-� J�
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