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I-; a � -� .� � �`� �,� � NN � � (Q i : I ; � O O n •-+� r � � � � � s �� , � W � � �', ;-i H j ; ,� � i APPLICATION FOR CERTIFICATE OF OCCUPANGY OR CERTIFICATE OF C4MPLETION COMMUNITY DEVELOPMENT DEPARTfv1ENT• BUILDING DIVISION CUPERTINO A�BERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTlNO, CA 95014-3255 �408} t77-3228 a FA>C(408)777-3333 � G_uilciinq�r�,�!r�ed_no o�;;. COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING: PROJECT-�DDRESS APN# ; ., _,, - DATE r � `�� ��� .5� � /���0. �'� �� �'���"� � :3�� a �§(t�2�.`; .��� " 3�� aF,� w. �Y_ Ot�\ER\A�tE PHONE E YIA1L � �=�� ��SC�' C✓i� I �'���r, ��`° 1-$I �: ��Y�� ��`=���, � �� ��� _> ��� � � � � ��� � STREETAUDRESS CITY, STATE ZIP 1'AX �� � ������, � ,��.'�A�°`� d�-� ���'-_ i ;,� � :,�su � `�--i���� �'�e� CO\TR.aCTOR V.�`.;E F c� PHO'rIE E-MAIL ''Y ����F � - �?� �-_ ►��1 ev�� �<�� � @��3� -, _J_ STREiETa .�DDRESS p C(TY, S/T�A7'E,ZI /,� f� ¢ F� _�� 6 6 �f E+6 �'<.^+�y� .. (-' �s_.V.-.3 -�:. �S�T��Z..�--+� fi+k�'� l4�� V �h � _ a �'.'� ,� E��hG �`� l� � , 4' MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery): CONTACT NAt�1E PHO'�lE �ti'�I- - ��t �3 a_3 -�� ��'ev3 _ r�� �-" =d s r�-::1 _ '?'�.�%�4� �Z a.�1 q��.-�'�—� �S�x 5::.�'8'��d—JC4�';c�s�s'�°�`; � J�)" __ ..�`3 �O� ._ - .� c,��, - y - STREET ADDRESS CITY STATE,ZIP g�, g F� _ ___. � � . . �1 P �,.:., r � �v��G��' �-.� { � d F� "-=e. - < �=j�c. �� � E�G,.r�,,�._��.�.5 ��-= � � �.e� �G �'-� �;��"� :J � � ��e- LIST ALL BUILDING PERMITS ISSLTED FOR PROJECT: PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE NUMBER DATG DATE FIri`ALED 1 y�,��-'`��s'y,,�a`J'�'� =�,�� a�'� �-y�,j�=`a � `�� �"' ��� � ���� [� a j:,=_ > ��� '�+ �0"�v � � �� 2 ���� � � l�. !y � L.�ea t� i��� 't�OD L C{ � � �.�� 3 ���°���� �r��� ��� ����r.;1�� ��,��g� �P����._ � �;�"��� � _ � E�Y � OCCUPANCY DATA: USE OCCUPANCY TYPE FLOOR AREA OCCUPAI�T LOAD 1 -4� , � e�_ �', .:� �` >:� � �_,�,, , yJ ��:� 3 � __ }' =� �- � � � 4j `1 ..J �J') 5"-' .�L-y - 2 �V�Y� /;� c�j rS �� _ � 6 6 ��-. • 3 �.� `, ` - o 4, 4 �(��y.�`,'+-,_.,._` BllILDING DATA: #STORIES #STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRINKLERS BELOW GRADE ABOVE GRADE FLOOR AREA LOAD REQUIRED YES OR NO PROVIDED YES OR NO �, � 'i G�� f� ,�i--,�p -,�.5 C�'� / i� C�^ - � �.�lj`6�,'_.c-^- �_1 = Y �+ G #PARKING #STAi�IDARD/COMPACT #ACCESSISLE REQUIRGD PAIiKING PROVIDED PARKING PROV[DED NOTE: ATTACH A COPY OF THE SIGNED ; ,�y �� � �, �-;, �� INSPECTION CARD TO THIS APPLICATIOI�T. - 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? CofO Application.doc revised OS/17/16 � crn�oF cu�Fn�i�o Hu�Lnmc r���rr��sr�cr►on c:�►z� 131'IL�ING AllDRNyS 104�5 BANDLEY DR CON"1'Ft•�CI�OR PI}2�1tT\O CIiPERTItiQ CA 950141912 KDLCOI�STRUCCION INC [3-2016-1722 PII2�ITT ISSUED: rJWV�2'S NAME 10.�14/2016 iWNIIt'S PHONL PHONENO: JOB DI5CRIPTION: T.I.CON\�1:T USE 7'0 A-3(7,414 S.F.)-CHINFSE CHUIZCF[lN CHRIST 7�YPF: IVSPECTOR UAT� YLU�t[i1XG UNUC-RGROUND G.AS PIPING INDFkGRGlT1D W'�PfR �'�NDERGROUND SEW ER UNDHRI=LOOR ROUGII PI.UMI31N<i SHO\VER 1'AV WATER 4IG:�TF.R WA"I'EH SFR\'ICL' Cv1S PRESS[,RL:I'ES"f GAS b1F.TER RE:LE4SE PROF[R1'Y(��H CLE.4\Ol;f PLUA4fiIlvG F1141_ � � F,GECTRIGll. urra TO ARR�UYGGINSPF�'I'[ON utiuF�toxo�v�� Call 777-3228 bcriticen 7:30 am and3:30 pm Monday through Frida}�,at least 24 hours txforc reyuired inspection.Jobaddress undPermitNwnbers are neccled�tificn rcqucsfing an inspectiun. WDERFLCbR cu�m�:�o sn�rrnKY n�s�ra►cr ROliG1�I L LCCTRII'rV.. Closed circuit�ideo inspection of prope�ty line cicanout,point otconnection rEa�Nort,aav i�rnvsa Po�r andstrcet latcral reqiuredprior to passing rl\AL C7TY PLli�'1BING II--. INSPI]Cl�[ON.Call tl�e District(408-253-7071)for an a�ointmcnt. -��.It`,-10E UPGi2AUL- ..�cr�iic tiaerrrc ar_,r�sr NO B UILDNG II,\US 1\SPEC7 iU�S UN"fIL ALL�t�Ul}2ND —� BCSIIHSS LICGVSLS ARI:OBTAINFl) �:ir_rraic ei�.ai. ��Fc��:t��c�t. ����rr�P�aH��r�voaK�s No�r s�r.a�rrm���mi��iso».nVs c�F���irr [Nn[:ar�a�R LSS UANCEOR 180 DAYS FRO?�4 LAST CAI.LII)INS PECTIO\. koUctt!��ecii��:cn� 1�'1['ORTANT�i'hen z permit has ex{ired,a charge totaling c�ne-half the fees to oUtain a newpernrit F�at�ntice must be�id in order to reacri�ate the permit.If a I�ermit has bcen ex�xred i'or more tl�an one ye�r,a chargc totaling the f'ull tees to obtain a new permit musT be Eziid A!R CONDITIONHR to reacti��te the permit. ;100D5 ?Y�Tn, . _ t .1 ,�_.V �i t�? F!' ' �-�- r�/ �1eCkLW1C'AL.F1�.4L � ` �-, � ,_,_� �..- � [.. ' J � ..... r-u,�x " . PLU\IHING � = ' - ` i�� f � r t.,�, t 'Lr ��'- f� �� _.� "�2� _ . , �� . .. � .. � - FL[CTICAL�'��� � /± �1GCI IANICAL � �����-��d .�_. � �.�,� i �i� P� �� ���_ s�.�+.:..::a�h-'+� "�Z"� v s_ i•i=� f P,I�ILDIVG�. P . ��� Fit:e �.i��;i ,;:,��.� y--f�,�3�va t..�� ��.,+�-°l1J $�,+��� ,�.i �';_ _ /.Z--/"�-� � S�1'I.1L�i1\G 1'UOL �ficl\FORCrA1I:N(' P,'blrE EI.GCTRICSf.I30yDMG � �ROOF[\G� . PRE INSPLC'f IOV TEAR OPF hlAll.f,IG �`ATTC-Ni I T4PE tVSPEC.TOR D.1TE T'1'P� I\SPFCIOR DATE- - 1Y1'E L�SPECIOR DATE � POLI\D:iT10\ � � S.iVT,.RY I\SPECTIO\S POOTIr:GS SHONER PAA1 UNDERGROI!ND �':fCR WATGR HHATGR Hl'DROFLUSPi — _� . �. r- � � :. ., �RS �7' �1�`� VVA'�ER SF.RVICH I '� � I � t) _� � �ifY"9 f,��9 tT'�,S .�-- _i�,_�s� C;NAUEBEr�h1S G�S'IEST I���� �7"L`�.�"" _' .. P:;P..� i a RIGFff OF\3�hY GARAGE SLAI3 GAS MEI'ER RELf115G — .r����CRO[t\D,'SI1E',1'ORK.. . -- GFcnU1NG i UtiDERGf20UND FLTC;RJC.4L I EL��.�r� RETA,^;v11,1G\5�r`.LC. IG�Di�2GROcND G.4S PI'ING TL•MP PO\VER POLfl I�NDERCiROi:t�DlV'.TER r� � �L/ SGR�9C6UPCiRADL' . ��FfREDEPAR'i'SIE\T � ,�,�.., SITE COA�fPLIANCE U�DEItGKOI;\DSLI�'ER �' � �� .-�. P\'SSS'fLM 4 .— �.�� ti '.y S1TE WAI.LS FIRE\1AIN S\'STE�IS - EV SYSTEt�9 — a I�Wl'IVG FIRE SI'RINKLE:RS-ROUGH �F :_)'J,,1 1 _ t �y .. �-°�v \�tASONRti'2E3AR �...��IEC'�IAVC�t:�� FIRESPRIMiLF�2-FWAI. I �a d( �• r.,,-�% — —�- DRAWAGC FL%RNAIJCE iIRL•ALAIL'vl FINAL -� � tt' �� ,,. , C + CMU WALlS QOILGR STANDPIPB SYSTE\4S tI�UBR[7.00R ._ AIR CO�1llIT10NER EVGI!JEHftEU FIRE PROTECI'ION SYSTEM �.1:'�DFRPI rpR PI IJ\f[3INu — �' �. --- HGODS fIRE LR'L S:1FET1' � �� � � �PI ��.._.; i�. �i�VDFRFLUOR kIECHAN?CAI_ .--� — Dltil'WR.4P I �UND(SLFLWR FLECTRIC.4L - ' pQ(:[;\7EhTA770V UNDERfL(X)R FRAbIIIv:;-- -- 'P-BAH VAQ'SLTI3ICK CfRTIPICATlO� UNOr_HFLOOkINSUL41�IiiN i PLUkIBING � ��RUSSES I I � __ I�1tA_171:�C � ELECTICrV. SP@CIAL INSPECTION REPORTS hL(�i2i\t �SHFalltl\t, I S\10KE'CA2AOV�tOVOY,IDECERTOF �—_ �1LCkIrWICA[. C0�4PLIA7JCE ROt CN Pl.�.\[3�pi' i', + - - -- �—�-"=��� EUILDING �VATER FR'TURGLCKT(T COMP[,I:1\CG _�-�_���_-IL__� �IROI(H;�iF�.�f^ 1C�d_—� --- --- � I `�-- FIRE EVERGI'CO.ViPt'A.�ICf:I�OR\15 �+)LGY.LLGC�RiC;AL � CALGIL'=EN bLANDAT02Y ITE\iti C'IECKL'.S C ( _?Ui��}i FRA:`.II�G �. � .S1\7�LbDNG YOOL —�--- i1:TE1�lORSHEIR I REINFORCEMFN� - �---� - _r_ DEP:\RTYIEM1T-FL\.4LS � Ii.KI�E31OR SIiT 1k P�A4�E � PL4\NI`iG-G\LL 777-330R � Q�; - -- N�.ailliJSll�t[10� � '� .Y„ ������. - LLHCTRICALBONDING PJBI.ICWORI�C-CALI.7i7-3:54 CEI[].V�IT��l,9A7'lOV � � �� DEMOLITION {'IRE CALL 37K-1010 � .:�y" '3 7 ��- � � � ,i�.` R(7JFN41�_WG I BACKFILL HEALI'H-CALI.40R,-914-3400 I -� �� I\ EfUOR F1;.lS(iES SANII'ARY C4L� 93-i071 I I — T I S�IcF1 TR°C k _ .. ....�RQOFI\G��.� � �. /' ! ..� . 1� � i�;-t' C - ��TiLt.JACKFR l�^.aDEkL1YG1ENT PRR NSPECTION i �.���i i i � � ' �i i��%� i �_�I ��,i,,,_,� BLIILDI\CFII':' � � II—III I?B.AC'KEi2 TF\R Oi'P PLU�IBNG �'�`5�.,� �IN� T?1 KIOR LATH � NAfLNG GL[CTRIC.AL ` � f -------- �-5 ' � �.�:rr:wo�tr��rs_Ftts Ia�rre�s n-i�c�ti�cn� — ��_�—�— I'L}.I�eRIOK L,11�I 1 ---- �I TEMPOR:\RYOC'C[,9'.�1.�:C1� �js� ��--1 !sc�nrc!ico�r_ I - - I3UILD('.VG :�� ';"��"'� IfJIV(� � �� I�_'__'- � }f. � . ��f.. �`� , . . . .. ._ . _, . . . -_ " ''T ��t�'i u�� ��,�-�:i��G�r� €�� � 'l7 •1� ,��v����c�/2 .�e��-�.s� /.�I�;�-� �!� � �I`''J 7 � _� �~� � �i�OFCLPERTt�03�eL��.:_-oER•,'r" �:P:�i7C)`�C3RD 3i[:_DI�G.�DD'r:�:: pER�3TTtiU - r ��?.-;\� . �_ ':O\iR-� _.-. - 2 CiTGRT1�t C��_ - _ _ �()i;\II2'S\.�:ff� PEF�ItT i��t:1;: ' _ _--� --=3y\ -. �- - -r. -- . _ _ _ - _ �I,\>>Fl ,�_ _ i\\"FR'�PHt)�T Pi's:)��\l.: IJOB D�CWPT[O\: �.,_�.]_ " :1- —ij \\J�'•,\� �.,?= '��\ _- I .�-t_ _ -- r �; .��� �� �"l�F� � � - .���(.1 /���l�� ;�jtC{i�.-.-'..__.... . ih.....-..-_. i��'.,.— __ -. ;!tt=.a::�_-:".'.:.- . :i'___ .. . ._. . T'J ARIZi�GEL\SPFLTIO\ Call'7 i-3228 lxntieen 7:30 am and3:30 pm\tonda}through Frida�,a[least 2�hours beinrr reyui�ed " !� inspection.Jooaddress andPermit\uml�rs are needed�tifien reyuesting an inspecrion. .� _ -_ '� CLPFRT!!OSnS[T.4Pt DLSTRtCT � � z - ; ---' - - Closedcircuit�itS�o inspection of proper•h�line cleanout,puint of cunnecrion - _-- _= i i� andstreetlater:ilrequiredp•iorto�ssingFl\ALCITS'PLL]1Bl\C LiSPGC"I"[O\.Cai!the DisR•ict(�OS-253-7071)for�n appoinm�ent. __ '_ I I� `` _-_ - I I� �O BL7L.DI\G FINA(S iNSPE,�17015 UNT{L ALL REQL7RE� \ BISI�l�;S�.[CE\SES AREOBT.��I!\iFD --V tc�:r€��IGat ' II P�t�II"I��P[RFS Ih'�VORlCIS�07'ST.RTID�b'ITHlN IRO DASS OFP£R�til _ ISSL:A\CEOR180 DAVS F"RO�oIL4S`I'CALLIDINSPE�C°I70\. �t��::���iCw �� I�iPORTAti P�S'hen a pennit fias exp;red a charge totaiing one-halTthe fees tu oL�iaia a ne�v��-sn;t -- must be Qaidin order to reacti�ate the permii.If 2 pernut has treen es�iredfoe�r�re ."'it`,`;�`= 1 than une cear,a chai•ge totaling[he full fees to obtain a newpertiui must be paid ,�,-; ! to reacfi�ate the permit. , , i I _....... _._.,_ � � �OTF:S: _- _ 'r-sn[t � � ... . � _ i� 1j,Ii�._.il.'.�..._ i I I� ;•,;>c � I ��.�— Si1�li3iR\G YOOL I � �!::4:\tl)'2�E.��\i I i I ��\5, I i ilLl Ji;i�;tl��L BOVDI\G � ;—-- ROf3F7KG � i'i'Dii i\SPFCiIOV � � ::�-C=.,LR ll�"r I . r`.1iL'�Ci � 1 STFVS I ii=_� TSP6 IVSPECi'OR D.4TE j�E t\+Pt�TC'4-_�-Dt.TF, �----TYPE [I�SPECTOR T Da'fF, "F---��OL�Zl�TtO'� PI.L`ttBT(�G i � _�� 84�ITiR1"li`SPECi70\S ;I,���I�;AGS SHOWLlt P,a.v G�UERGR<�GND il�`-�f: !IVATF�2 HF_�1TEk HYJRUFi.USH i i�R`± �O'�\TFR SFR\9CF � ,_..:;2,�Df HGA�7S G.AS TLSl. .�. .. . 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