B-2017-1993 - COFO � i •
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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.org
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS /UCJZ� V'✓`�lln�,� C,�� pPN= � ` �I � � � ! �. DATE �/�� � ( �
( � ! —I �
OAVNERNAME PHONE , �- E-MAIL
1�� %�� �c�«, � 6s� �-��t� - ����, b��z.��.:z�9�C� �����( c��
STREET ADDRESS % G L Z� ���K`� �A � CClY, STATE,ZIP �� e✓(2G v ��� �3 ?v�� FAX
V� !�
COVTRACTOR N.A�1G L `J�\ {. ,_ ..i 1!��1,,/� �/- PHONE 1I, /��3 E-�fA[L
e'1"7',l;i 1 �� � �V v
SI'REET ADDRESS CITY, STA"IE,ZIP FAY
C c�c�� 0���� �� (�;� �,-���� C���%s�l
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACi NAME �7_, �- � E-NIAIL
�.f�'r'��G1 �<1--w�`� PHONE L,��' � 1� t� �-��-e'� ��<'�U I�titC/l��✓�' G C2�,)� CC--�
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STREE7�ADDRESS CIT1', STATE,ZIP ��C� .,�� - ` i„ �� - F,4\
��U Z G c>:-�..,,��� �%��e_ '.{L ,,� C(f-� �L -
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERiVIIT SUBNIIT ISSUE DATE INSPECTOR SCOPE
NUNIBER DATE DATE FINAL�D
1 '��������� � ��(� I ��� Z �t ��"h �C-'i'lc,G�'� �vvi ��v���-v-�-'_��-�.
2
3
OCCUPANCY DATA:
USG OCCUPANCY TYP� FLOOR ARGA OCCUPANT LOAD
1 �C=�Z��'( � �� o
� �,l✓° :Sc�.loi.n � - � .
�
3
4
BUILDING DATA:
#STORICS #STORIES OV�RALL bIAX OCCOPANT TIR�SPRINKLERS FIRG SPRINKLERS
BELO�V GRADE ABOVE GRAll� FLOOR:1RGA LOAD R�QUIRED (YES OR NO) PROVIDCD (YES OR NO)
`)`�6 ��r'�-
#PARKING #STANDARD/CONIPACT #ACCGSSIBL�
I2CQUIRED PARKING PRO�'IDCD PAI2K[NG PROVIllLD 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)?
Perniit Signed off in system?
No other pe�mits open or expired in system?
Location of Approved Office Set?
CofO Application.rioc renisecl 0�/17/16
CITI'OF CUPER7'I�O B UILDING P II2;�IIT I\S PF�'I701 CARD
BUILDL\GADDRESS 100'60R,4NGEAVECUPERT[I��O,CA 950142516 CO\TRACIOR PFR�IITNO B-2017-1993
O�'�'NII2'S NA:\IE PHONE PIIZ;111TISSUID:01:'17;?018
PHO\ENO: ADDRESS:
T1PE INSPFCTOR DATE JOB DFSCRIPTION:
r•o[nvnT�o:vsiTE wo�uc �AM[MPROVF�4ENT(996 SQ Fi)-EPRIS�4ULTI SHOP.
PIERS �.s� /t `.,.
FOUl�'DATION '�,� a"t`� '"l.�"���'�,� V��A,��`t (;� �1�A�1�4ri1'��A.��t��l`1'� I7���`�..
liFER C�tOUI��D � €` �
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GRADE BEAM
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REIIvFORCEMEh''I' <_
p4ASONR�%STfiF[ �
COLl,�9N STEEL
RETAINING WALL
ran�nnc
UNDER FLOOR FRAMING
ROUGH FRAME
IXTERIOR SHFAR
iNI'ERIOR SHEAR
ROOF NA IL
T-BAR
n'���^�C�- TO ARRA\(;EINSPF:C"ITOV:CALL 408-777-3228 BEI1\�7:30 A.�Z,�.\�3:30 P.M
UtiDERFLOORMECHAN L A10NDAYTHI20i:GHTHLIRSDAYOR BEI1\'FFi\7:30 A.�1 A:\�2:30 P.M O\FRIDAY.
ROUQ-I�9ECHANICAL� � CALL AT LFAST 24 HOURS BII�ORE REQUIRID L1'S PECTION,JOB ADDRESS A:\'D
FURA NCE
PII2:�'71T\U1VBIItS ARENEZ�DID 11'I{E1V REQUESTLIG,�.�I�SPDCI'IO\.
A IR COVDITIONER PFRI�tIT E�:PIRFS IF��'ORK IS NOT STARTFD�1'ITHIN I 80 D.4�5 OF PEfL�llT
BOILER 1SSUANCEOR 180 D.4YS FROM L.ASTC.4LLFD L\SPECTIOV.
HOODS NOI\SPDCTIO\S FORBU[LDLVGFLIA[S C;�'T[L,pLLREQCTRIDB[,ISI\E:SS
DUCT\uRAP LIC�SFS AREOBT.4L'�ID.
ELECTRICAI.
T1PE INSPECTOR D.4TE
[,R�IDERGROUI�'D ELECTRICAL sa�rraa���n5eecrio:�s'
UNDERFLOORELEC.T AL U1�DERGROUI�'D
P�OUGH EL.ECI'RICA HYDROFLUSH
PV SYSTEM VISUAL
EV CHA RGING STATION GRFASE I\'TERCEP7 OR
TEMPORA RY POti'ER POLE rue��c��ouxs
SER\�ICE GPGRADE R1GHT OF\1�A1'
Ei.ECTRI C'V]ETER RELEA SE GRA DING
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UNDERGROU\D SEWER S1TEC0\9PLIANCE
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UNDERC�ZOUND GAS PIPITiG FIRE 3PRINKLERS-ROUC�-1
UIVDERFLOOR PLUMBING FIRE SPRII�'KLER-FINAL
ROUQ-I PLU�IBING �C'� � ^ FIRE ALARtvi FINAL
SHOW ER PAn' STANDP[PE SYSTETviS
WATER HEATER E7�GIT'F.ERID PROTECTION SYSTEM
GAS TEST T-BAR-FIRE
GAS�4ETER RFI.EASE :�nsC.[�SrEcr�o�s
[:�Stn..aTto� DE?�90ll7101�'STRUCI LRE
U?VDERFLOOR INSL24TION ACCESSIBILlT1'
INSUL4T10\� T.I.PREP
�`reittoa I ExrE[ttoR ec��SttEs TEM PORA RY OCCUPA��CY
SHELTROCK nocu�tenT,�Tiov
IMERIOR LATH PAD/SECBACK CERTIFICATION
Ea'TERIOR LATH EPDXY OBSERVATION LEiTIIt
SCRATCH COAT DEP.4Rr�ren�r F7\nL,S
s�rmL�t��G Poo� PLANNII�'G-CALL(408)777-3303
POOL PRE-DECK PUBLIC�'��ORKS-CALL(408)777-33�4
POOLPRE-GUNITE FIRE-CALL(408)37811010 �,�.�, ����t�
POOL PRE-PLASTER SANITARI'-CALL(408)2�3-7071 i
POOL DE�40LITION BL�LD�NG et�.al,s �
aoor�[vc MECHAI��C.4L ;% G` ` ` �
ROOFPR�WSPECTION ELFCI�RICAL ,k �L , �
TEAR OFF PLUMBIN /
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BATT�S � -� ' ,)
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