B-2016-2456 - COFO • •
� � �
0
� � o I a�
� � N � �
•�� Q � z Q
� � � w N
�
'C � C,) O � �
U •� � � W O
3
� � V
� �
-� � y�-' " � `y
U • L � � c
� � o � � � o
� Q- c � � � � o �
� c E o � a� � -c `°
� � v ai c Z � � C ,°
� •� L L � � Q M p � ,(�
m � j v c�n Z II � 00
� � � � •� � w O ~ 4
c � � >, ~' o a� c
U � �
� � � C � � � � a
� � �.� Q � � � � �
V � � � !� �, '� m
� N (� y G�
m � .D V Cfl ti � fn � � w
O � � � � `� � N O V O
� N � .� � N W M1 � � ,�,
� � � � 0 ('7 Z � .= G� L
L- C> O
+� � � Q � z 0 p- Q y �
o a�'i ° 00 tg � v� U ' �
N o `' �- � N V � L � co
� � U� � o � Oi.i a L -� c�', w
�' � a� � � � :-: o ° � � .a
y� � � � � � � � v� � � Q � � � a�i
a�
Q � N � 3 ° N o � m � � � L� � o �
a� o � Q �.
� -� � � � ,a m W � m �� � �� o v
� ° � � cn 'a > c�i � o > v�N :� w 'o
.� � � � �, m �-� � Q� ,� � �
�v E
�■� � 2 0 � a °' � a .� � � v� °0 z z �
� C L
� � c� N 'D y�„ � � c� � � � O � �Q
•� � � � C� L.L Z � +`-� Q� � (n � ,t�, O
� � � tB U � � O �+ � � � Z V � �
� L O > C � � � (n V O U = � � � � �
� � C � Q � � O � � � N � C � �" � � v�
� +. O � � N ++ �- Z Q O � C �� � � � V
.�i O � c� � N `- W � � +. c6 � N Z � C
� -�' L U � w U (n (n � � � RS
� Q-� � O tn F_- � V >+ � N � N � � .p vi
(� � � N �t � �-- ' CO � � � c0 �
� � -� � C m � C� O � N � O � � m � �
L (� O $ ` u1 c�
� Q U � .� ^ 6 � � � O� 4
� � j � cn Z � m
c �,
� � ° � � cy � 'vi O � (j z ,�
c�n � .�' � � o � � � Q � � o
.� o � c� � � c� 0 � m� � � a Z
' a� ° Z � � -�Q c c � �� � C'i
� � � � •� � � � � oo � o Z
C�j �' � L m ° Q Q- � U U (n � � �'
�- N � � w- � — � O �
.� � � d O c0 O � � QQ J � 0
� � � � � o N � � .-• � � a � (/� W
U ca '� � � � � LL. c c U
� Q � � W � U
� � � � L L � � ^ -Q O
� . � � � � LL
H L m Q cn � � U U i.L i.i � Q 2
• •
# `�a�.�.. �•�,r+r-t . . ....... .
APPLiCATlON FOR CERTIFICATE OF �CC�PANC�t
OR CERTIFICATE OF C(?MPLETIflN
COMMUNITY DEVELOPMENT CEPARTMEN7•BUIL[3lNG�IViS64t�
CUPERTlNO ALBERT SALVA�OR,P.E.,C.B.C}.,SUi�#�1�lG OFFICIAL
103tI0 Tt�RRE AV�NU�•CUPERTlP10,C�4 8501�1-325�
(4fl8)777-322$•FAX(408)777-3333•buildi�qt�cu�aertinfl.orc�
+�aMPLETE A SEPARATE APPLICATION FC}R EACH BUILDING:
eRaEcr nntaaess Arn;� uAac
�'S 21
oww�Rxnns� �.�a�: e��.ar►
�t� ') � '�i.i�P�tt F 1�,�,E:t�'
STRF,L'4'ADqR�SS CTTY,Sl'aTl[w 21P , �l p Pt,X
Sw�
CON7'RACi'tJR NAME � r{up —2� 7'� � T:1t4;tlL. �`' ri.[1.
���
Si22ELrI I�DURESS GI i'Y,SI'ATE,ZIf' FAX
= a r � � L —�23-- !30
MAIL CERTIFTCATE TO: (Please aliow u to 1 Q business da s fc>r delive. _
CONTACT NAME etto;v� x-�sarc
a 7� -��+.t� �
SI'RF,E'CADpRESS CYI'1>SI'A'i'E.7,IP FA?f
i S'0 0 9 �7'
LIST ALL BUIL,I3ING PERN£ITS ISSUED FOR PROJECT:
PERMI'F SUBNllT IS5UF. I}ATE INSPECTOR SCQPE
iVITMBEit DATE T1ATE �1NAI.EB
� — D � t
2
3
C3CCUPANCY DATA:
USE OCCiTPANCY TYPE FLOOR AREA O�CUPANT LdAB
i Re : � e l
2 -
3
4
BUILDING DATA:
#ST�RIES #SI'ORIES OVERAI.I. MA?C OCCUPANT FIRE SPRIl�'KLEAt5 F[RE SPRr�tn.Fgg
BELQW GRAi)E ABflVE GAADE F7AOR AREA LOAb RE UIRFsD flR l�0 PRQVIDED QR IVCi
tS�'ARiQNG #STANDARUlCOiliPAt;T #1 ACCESSIBLE
RE ur�D PARKING PROVIDED PARK�IG PR0�7DED NOTE: ATTACH A COPY OF THE SIGNED
L�TSPECTIflN CARD TO TH1S APPLICATIUN,
- OFFICE USE ONLY-
SPECIAL 5TIPULA'fIONS OR Ct�NUITFONS: CHECKLIST:
Copy nf Jol�Gatd Attached(both sidss)7
Pcrnui Signed offin system?
IVa other pamits open nr expircd in system?
Lacnaon of Appnovcd Office Sci?
Co�ApplitYrtion.doc reuised 05/!7/76
f `Uo�e.. ••`�.Nr, . . ....... .
APPL�CATI�N FOR CERTlFICATE �F OCCUPANCY
OR CERT�FiCATE OF COMPLETION
COMMUMTY DEV£LOPMEI�T DEPARTMENT•BUfLDING DIVIS[ON
CUPERTINO A���RT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
10300 TORR�A1/�NUE•CUPERTINO, CA 950�4-3255
(408}777-3228•FAX{4p8}777-3333•buiidin cu ertino.or
COMPLETE A SEPAI2ATE APPLICATION�OR EACH BUILDING:
P$OiECI'ADDItE.S5 APN#? DATL
�� 2 �
OWNER NAME P4�ONE �r /� E-A4�[3 �"��
T�� / '�.WYrL # r��;/�/
�
SS�tF,ei'ADORESS CTfY.STATE,ZFP T' PAX
aV�
CQNTRAC70RNAME I P�C —Z3 �G� p ��•ta�[. �� r�.f'4
ST1tErF ADDRE55 CITY,STATE,ZiP �AX
? �, r 9 z z_ -�2 3-- 13 0
MAII.CERTIFTCATE TO: (Please allow u to 10 business days far de[i�ery):
Cd1vTACT NAMF, PHONE E�ht�IL
Qit/l a '71 -�,Wtn(� D� .
5'I'ItF.Ef ADDRESS CS"�Y, SE'AI'�ZSP FAX
� .S`U a 9 �7�
LIST ALL BUII.DING PERMITS ISSiIED FOR PR�7�CT:
PERM.["F SUBMIT 1SS� DATE INSPECTOR SCOPE
�TLJMBER DATE BATE FI�iAI�ED
� _ � � rd
2
3
OCCUPANCY DATA:
LTSE QCCUPAI�ICY TYPE FLOOR ARL�A (�CIIPAiVT LOAD
� Qe ; � 2 B � ! � .
z
�
4
BUILDING DATA:
#STORIIrS #STORIE.S OVRRALL �i.�X OCi.'FJPAIVT FdR.E SPRIr"KL�RS F[RE SPRIl►11�.ERS
�ELpW GRAt3E ABOVE G1tAI1E FI.00R AREA LOAIi REQl7IRED (YE5 UR 1�f0 PRUVIDED oIt n'O
#1�Axtl�vG #STANDAR�/COMPACT t!ACCE5SIBLE NOTE: ATTACH A COPY OF THE SIGNED
[tE i11RED FAAKING FR€lVXA�D PARKIIVG PROVID�D
YNSPEC'I'�ON CARD TO THIS APPLICATI�N.
- OFFIC`E USE UNLY-
srEc�.sarrnv�.ATTo�rs oR coTrnrrrorrs: c�c�.rsT:
Copy of 7ob Card Aftached(both sidea)'?
Prnnit Signed off in system?
IVo other perntirs apen or�pited in sys[em?
i,ocnriort oCAppro�cd Of1"ice&et?
CnfO Application.doc revised QSI17/16
y
, � LnYQFC[Pl1Cl�IU$[�11�Y('PPRl4[I'�SP�.�lIO1VG�RD
[E��1["AD�B,48
14YS9SIEVSVSQtP�BL`1D !YO
��'�4 G195014 T�1R[3iC�'fON S&tV�ClS a+IC 201�2455
S NA�� SAIm 1�fILRD SI�?A1 Mfl+IIA PARK G 9W2�705? B&i�:
S�'Q,�'StTi�DA(�f3t8fiA?QRI.LC IO�i9�"1A�6
WlV�'S PSOd� • MO:
(�D64�
S18 IlOS 1SF PI]t,]�AN�T.L OF'FiCL�(7,320 I Sf FIJ�7521�',T07'AI,3,on sF�-cio�[�rr
oN oe�ra�rRx
TYes �se�,.s+ae n��nt
a►n rae�a
NRI'�
38VY�
� -
r�t
.�r�t�►ra�
A'!'a[�V�
?iIBS'S[�!8 7PST
1�fH!1tBl�1�48
11�6 QE�1J1'
TNAI.
. 7�D Ait�tAlY[�1�8l�.'�pN
c�n rr1-�i2t�eel.+ee�73t�ais:3��.Mr�yr�rw�Y Rf�r,�t Is�c s1 r..r.L�re r.,�[re�
[�rpeeli�.]ia#at ari��it[�eLn�e�c�ee3ed�iroa iaratk��l��eeli�,
wea nx•�r Cil�7�T0SAI�RI'AIHCq�'�CP
pwe�dre�it ii�i��rpttka d�erh li�e ejew�,l�i�t de�eiw
E1a+OtuY[K7W1Bk P�o18 �M�aeot l�Ivd re�irritri�Mrlwsi�ITiAL(�1X?Ial1ltPIG
VlE�t�CitA�18
�B?�"�.I��cD6h�ict(4�i-2i3-7�Yi)!r��I��k,
1�S18t R�B� NO Bt�pI�1AiB I+8l1CIf01�3 iN�I�.AIL I�QiSt�
� �
s[B�s�s�,�a�a'rne�u
r�'rx,r��w�ow��rtores�ru��wa�r i�n�'�oirrot�'
�ss��o���nAts��rc.�a��sr■cmN.
�''�' 11�[1�[7'A1V7'.Wita a per�ttMr aqfred,s�e Id�e��e iea M�W.a�ewper�ic
rr�t#6e}�iiia�r�s M rdrc�wk�e gr�it!a�nit Yr beea e�reltr aw�e
Ir�e 3ar+a etur�e�I1tiR!M�(�Is�a�ewprtr�Et�tre�i
Aat O�rt7o�Ht M�aidiw6e 11�s�t
�, � �: �'l�"►���^ � �:�`'�'� �k��� o K '�r'/�
��1�� ' rK����'� 0� �C�►o�rN S�L,r4 � .
� ;�,.,. � s�, tti�1�s �vs�•9I����`'
�,.,��u� f �
Ib��$`�S �
� d!t �c� Cr.�� �''r,.c�� ����a�� ��
„� � ' v,v [ JI-!S'/� �--�
r�.c. y .
�' . . _, r�� �ar►� 5���� s �g5�
���� �
� �� /f/ry
� f r. r/.� �,/ �
�� �
rww�rrK,�s.�—
:i.._.«.r ��'�'-- Il�'C1R 11AT{L 71'� IfiSlt(.'I'OIF IlA'[8 7'YPE T1ISPPA.�TOIt 13A7Z
'�I�DL��1T4'!K � p�,tf.lBpy(' _ SANTARY ASPE(."lf01'6
����'� uHC1WPR PAN i ik�lE7t{d�QY�
��M � WAiFitE@iATFA
HYORtlF'L.L15H
��� .r WA'I'F,R SFRVI�
.7lAl�BEA1� TFSI' lURlIC M�1QfLS
�.�C�5Lf9 �.���$ RN3�f�WAY
�,,�� 1../ �
f�
lN%�L(�tfAM]BiA'fRICJ+L
_,_......_......�._._ �cu, —_ �r�n�m+c wau
L�f ORS PIPR�G FUW�t 1'OC8
lll�RatGR�ID VlATER � F1lV[CE UP[3tAT� P61�LRiTA�[I�l1`
��c�.oiw s�v+m� svs�r� ����
�� �!�y,
�w`� sYsrnN �nuw s�rs�
�,,,..._ FIRE SPlt➢�tCiFRS.AOEJiC4i ��'�,'I M�vt.��
�-(I�1itY RLiBAR
— . ��AL F'➢tESPRA�iCLF3t'FRNAL 'I�'
l/uQt.
�r. FIItE ALAR.�[F7NAL
WA1LS ~
�V�P�E SYSTF,1�
�11'�
COI�X[i�lt FIltE PR.7iBLTY�F SYSTPId
PI LB��Qld
t'il�Ai+IllC1l?�At�Chi � �SAFE'fY
IJl1CI WRM
CE'd�RF11Y.1i1$1.fiCTRSCAC
U�IClA�fA?ION
x7 V�rdYl3
'f,ilAR . AIYSETBACKL'PRTIFf['ATION
i�'t1E�liOC+it�i3�L][.�'1�Q�f [�.1.17�1W13 [)SSFS
�lKtxhd�piG . �y��, BQAL EhSP6CTlC�7 R�ORTS
1RY�VJ[1SI�+LTHfl�[1 � 8(I�MRdR}�L�tT OF
t7lK�ii F'C.�P�B1P1(i �
-��' WATFR FATl3ltE C�It'C GF CU!@IJJhN[E
1
i;lii�:3i2�]A'�CAS.
' � Ftd�A(35'C[IPr�i.L1NC�Ftl![.Q
9t7[.Kt H131.'1'ItIC.9i
CRI.QttFNlI�I'�]ATQ9tY�!'DAS�T
i�Y�"EX�i Pf��!HII�� 8a'Q1�f�i0 2'C�OX. _
!"'."kICIC�R Sk�.B �tCL"1{{�1C
-- - ...-- �AATAffi�II'PL�EU9
.7iS'[�l[lCt��,4iL –�� A+1IL= CAILTl7,i308 4 L
eGa
V�AtIII�b"l�Lt.'"Y,1kkr i ' 9t�+�Id WaRKs-cAti.7r.�354
...�.7NQ lla5UiATlLtr ^,l^ �
Fpt£-CJ�[h,b76a01Q
ItL7iCi�?+LiII.aiC3 �� ... ^...�. 1H•G[L�06�9i&310Q
.,.:-:��.;�. � A1tY-GC1253�707'
H�TI'R�]LK '�y�
7'¢P$A[3�x lki�lw�'I�+XP • RL'¢VSPBL'f#Qv`
���„ 7E1[i�l�'FQGia
awc�e . a� �� 2
rm�.�ar�r� .
, � � �
�wrra'
— T�fPfRAAY00'LSPANCY
T�7f OQA'[' �� � ��
,IIffilt3 �.