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' � C� � � .� � '� � � a� a� o .o � o Z U ''_' � i m � — fl' � U U (n � I� � � `F- � � � N � � > � � � � � � O � � d � �- �- Q � a � � U � � � � Q � � � W 'C U � � � "a O � � i � � � a � I � L � '� U cn O � � C C � 1- m Q cn � ti U U i.i ti � Q 2 � �.�:� ��` APPLICATION FOR CERTIFICATE OF OCCUPANCY � � OR CERTIFICATE OF COMPLETION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUP�RTiNO 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: PROI[CT�AyDDRGSS , � )`A� /� �/1 /�i� APN= DAiG 1 I 2 V �' Q � V'/'/ Ce �� 'J � � I�c� � � '�� ON' ER NA 1E PIiONt: F-MAI[. J ���� /�'c �rS /�T N� Ert�S ��E� ���3t�"-zJ /i, ,�,���L� ti/ i.��� .6�-i�i 2_i�►- ��vc� Z�v ci�.ysJr��re.�77/`�� C�" �S�/ �jL r.�� C VTRACTOR NAA�IE PHONG E-.\LAIL �'r� - I'►'��`� �LC��ZT/�'� ��i�r f i"; � 1?� 2 c� 1 E�� �J C�1fi�«�r C�C�Z����/✓C-<<� ,`'�/, 'I� ,�Cl� ST T ADDRESS CITY. STATE,ZIP F;\� rt� � �qy2 j�'i�i�- �� �f�.�/�trn�Lr/�t7 � " �1�� MA1L CERTIFICATE TO: (Please allow up to 10 business days for delivery): COATACT NA\�tE PIIONE E-�tAIL mii ,e � f�S���.�V (�s� 1r�,�� i�- • 3 �»�c��i-�z (� ��ic���s�z,�es', sZ�r,aoo�sO /� ��.�,�� _ Y✓ 2�? ciTv. sr.�TE.ziP , r;�� C_.£)Y�^ C v;�E�Ti� C/9 �?Lb S< LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: PER�11T Sl'Bb�IIT ISSUE D�1TE INSPECTOR SCOPE Nl'J1BER D:�T'E llATF, FINALED 1 -24/�' L�J�'' ��� ��• I���C I i � 2 � OCCUPANCY DATA: USE OCCI'P.a\'Cl' Tl'NE I'LOOK AREA OCCI'P:1N7�L0;1D � ,e��t.� � c. �i-, /�.:� ,s�z s. �=�, <3 �5� 2 , � 4 BUILDING DATA: #STORIES #STORIES O\'ER:�LL �IA\OCCUP:1.\"C FIRE SPRINKLERS FIRE SPRItiKLF,RS BELO��'Glt4llE .aBO�'E GRADE PLOOR:�RE:1 L0:1D REQI'IREll (YES OR VO) PR0�7DED (1'ES OR\O) � �� G S�z- � `/S� j'f:-'.� �"'��:S , #P:IRKING #ST�\D_1Rll/C0�1NaC7' #:1CCESSIBLE aFQLixE� r:�ah��c rxo���En P:�RKING PRO�'IDED NOTE: ATTACH A COPY' OF THE SIGNED ���- ��� � � INSPECTION CARD TO THIS;�PPLICATION. - OFFICE USE ONLY- SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST: Copy ofJob Card Attached(both sides)° Permit Siened o�t�in svstem? No other pennits open ar expired in s��stem? Location of Approvcd Office Set° C'qfO:lp��liccrtion.doc rei�rsed OJ 17�16 '�_ ' (71'Y GF CUPFRTINO BUILUING PIFMI7'INSYFY:ITO�V CARD � � B LI[,DING ADllRFSS --- CONI'RACI'Cl2 -_-�- - �_— PII2NIlT NO v— �2G590 HO�L•STFAD P.D CRpF['SMFTI COLLLCTIVE CONSTRLJ(TION &2 0 1(i 2 9 8 0 CUPETZTINO,CA 95014-6302 _ OWNIIZ'S NAME 10600 N DE ANZA BL�D UM1'200 C:[JPIItTINO,CA 95014 p�T LS SUID: SOBRATOINTERFSTS 1 EI'AL O6/16/2017 OWNII2'S PHONE `�_ � � PHONENO: JOB DFSCRII'TION: ' FIIZST FL.00R;'C.I.(9,99�1 S.F�-PEI'(7�JII � ;�yr� INSPECTOR nn�re ��V.� / ��O f' 00+�/�/ CE7t-/�!6 FZ7le T�✓a pLtm�n��c UNDERGROUND GAS PI}'ING . "(7 A�r!/e'�D�S� D FF/CF �Nn E k /T C�O��/OQ l2� urro�caoun�H-nT� _� C Y TC-�2/D� cS 7-v C C� - /SJve"� B'I�.i/i� � UNDERGROl1ND SE.'WLR 11NDERFI.00R , � . ROUGH PLUMBING --- - � � \• SHOVIER PAN ' WATER HEATE2 - WATER SERVICE GAS PRESSURE TFST '-'�-` . . GAS METER RELEASE PROPER'1'Y IA'Ei CLEANO�JI' PLUMBAG FPI.\L ^ ---- F.J.F.C1'kt(:AL � � �� TO ARRANGEINSPDGTION ui�'ot.Rc2oLNn v'^� Call 777-3228 behtieen 7:30 am and 3:30 pn Monday through FYiday,at leasi 24 hours before required _ ___.__ _ inspecrion.Jobaddress andPermitNumt�ers are neededwt�en requesting an inspection. UivUERF[.00R kc.uc�i�.r.cr[ucnr. CUPIIZTINO SA!VIfARY DISTRICT _�_______ ____ _ Closedcircuit�ideo inspecNon of property line cleanout,pnint of connecUon rr't,moua,ttv,owFR POCF andstreet]ateral required prior to�rassing FINALC7I'YPLUf1�ING -- -�-- ----- INSPFX,'ITON.Call the Dish�ict(408-253-7071)for an appointmenL SERVICE Uf'(�.ADE E[.�cruic hirrm ar�a�e , NO BUIL,llING FINALS INSPDCTIONS UN1a,ALL RDQUII2ID ----- ---- — BL�INFSS LICINSES AREOBTAINID er.ecrKtc�iw�. NECHe�Ntcn[, PIItMCI'F�PII2F�S IEWORKIS NOTSTARTEn WITf�V 180 DAYS OFPIItMt'I' E I��I:�� LSSUANCEOR180llAY5FROMLASTCALd.IDIlVSPECTION. kot1GF�h'¢�t�nn�[�A` IMPORTANT When a perrtrit has eapireci,a charge totaling one-half the fees to obtain a newperrmt �eimN�h,�E A . � must be paid in order to reacdvate the permit If a pernut has l�een esry'red for more - -- -- v than one year,a charge totaliug the€ull fees to obtain a oewperarit must be paid �Ant Co�rrloNEa to reacdvate the permiG HOOQS ---- 'ti:ECHAi.'ICAL FIN.aL NOTES: 7'-RAR PLIR.�BiN(: � FLFA'TICAL ! �-----�---- �MECiiAi�,CAL I3UIL.DINC .v� _ . �F�aE � �Y I tiRT:11117iNG POOI. 1 RF:IM'OIiCIiMFTT� -V-- � �-.-'_---'�A_..�__._--- ?�M/C �''Li:Cf'RICALB(N�UIT'G A —'-----`---- - � I<UOFIVG . _�.-- _ - PRE WSPG(71'tON TE.�R OFF � �_� _ ,�TTENS--'�"=- —y- ----- --_- — �— — F f �6 TYPE � IhSPECCOR DATE TYPE� �VSPF.(TOk DATF, TYPE IIVSPF.C.TOR DATE FOLIM1T7ATI0`i PLIni6IIvG SA`7['['AAYINSPE(TIOtiS ` �F(IOTPiC�S SHOWLR PAN -----�-- —! � UNi)F�E2UROt1M) . UFE7t WATEIt I-IEATER--- - HYDROFLUSH � I PIf7L� -- ' WATFR SERVICE y_' � IGRADE SE4DAS — — GAS TEST ") 11 , � � . P��C WORKS ('y�DahP�SLAB '�� . GAS h1ETIIt RII.EASE � �' WGNC OF WAY GROUND/SITE WORK ���' UNDERGR(H1ND II..E(.'CP.ICAL . ELECI'RiCAL� RETAINING WALL -- i . UNDF..RGROUND GAS PII'ING TFMI'FOWLR VOLE LINDERQtQUNDWATER � ' SERVICEUPGRADE —`— ---- F11tEDEPARTIITEI`IC IUNDL-R(H:Oi1ND StiWQt � � V.SYSTEM -� SITE COMI'LIANCG_�`_— — ����y�� �FIRE MAW SYSTEMS �� � � EVSYSTEM � POOTING � � `--- — -- F[ItE SPRINKI..ERS-ROiJ(�-1 jy�;�.,(+j���i�i,l�:"'' �:�...,q., ��i��Z i" MASONRY RGBAR ' FIILE SPRII�tf4..F.R-FINAL � ��'r��� � MECH�L�CAI, � . DIiAINR� v FCIEiNANCG � FD2E ALARM FA]AI. � �w� � CM[J WALLS BOII.OL . STANDPIPE SYSTFIv1S ��"�'nvR `�� --- A6t CONDITIONQt FNGMEEREI7 FIRE PR07'ECTION SYSTEM Utv`DER}'LOOR PLUMI3QJG — -----. — —_ HWAS FIFiE LII'E SAPEi'Y LII Ji.DERFL00R MECFIAN[CAL — �� -'— — DUCT WRAP IfNDFR}'LOOR ELEC"I'RICAL. — DOC[ANF:(YI'ATION lfnDERFLOOit F.RAMQJG .�._�� — PAD/SEI'6AG!C CERTL ICATION Ut�'DERFI.00R MSULATION PLUMSAIG ' TAUSSFS ���G ELECTiCAL SPECIAL INSPECTIGN REPqRTS F[.00R NAII/SFfrAT"r1ING � SMOKE/CARBON MONOJQDE CQtT OF �------ _ MECHAN[CAL �R(X1G}[PLUMBING COMPI..IANCE � -- �-- — �_—_ BUfCD4JG WATER FIXTURE CERT OF CO;vfPLIANCE �ROUGH t�'.CHAMCAL --- F� Etr'ERGY COMPLiANCF.FORMS RWCriiEZF!'TRICAL. ----- � - - CALGFLEEN MANDATORY ITEMS CHE(:KI,IST ROUGFI FRAMING SWIhtM1fQ�G P(�L Q�fI'ERIOP.SI-IEAR RIIt.'FORCQvfQ�Il' � ! DEP.�RTINENC FINAI.S � �EXT'ERIOR SHPAR P/M/E PCAM7¢�G CAIJ.,777-3308 WAL.L WSLII.ATION Q.F.CfRICAL BONDAG PUBLIC WORKS•CALL 7773354 CIILING INSULATiON DEMOLTf10N FIRE-CALL 378-4010 � / p `�1'^ ( / ,.., ROOF NAR.A}Ci BACIffII,L � }[gpLTH-CALL 40N-91&3400 INI'ERIOR FL�i[SIISS — SAM'PARY-CALL 253-7071 SIIIEE::CROCK - �---�+-!-�-� � — R(�FIIiG . ," 1_.r6'\:'�'1 �:. �-y TILEBA(.'K�EIi[.TJDERLAY,'v1E.N1' PREINSPECTION 1..�.fit°�S,j.�j��,:•''-: 'r C —I i t��'lk �"'�Y E - — � Bf1II.DING BINAIS � TQ.E BACKER . TEAR OFF PI.UME3ING 2�,� � -12-I�S r�Q�Tf7t10R LATH � �� NAO.,AG p_,g���pt, ,�.�— -�.._r -�j�i �'- ��.�atok Fv�as�s Bnrr�s n���inNicnt. '�.f�"L � `��� Eai'ER?OR LATH — TIM['ORARY OCCUPANCY - SCRA1'(,'H COAT �--�'--'-- I BUQ_DING r ,j�t" �/�l�� �-------��