B-2017-1015 - COFC �—
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTIN� 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: 3_2o t'�.- ���5
PROIECT ADDRESS APN# DATE
t� i o .��q-�,�� �, . �, CUPERTINO, CA �ZG 3�-{D 7 / �J�� ,
OV`TlER NAME �I,i r'�--�""�.�)��.�.� ���'� �� i . PHONE E-MAIL
c :�k,� �s-- Z�7-G�M�w ���� . co�nN �uk-aiSoN �k�4�u�� w��
STREET ADDRESS CITY, STATE,ZIP
f� `�r� ^ `Z�c^i1cfL : S� � �tS1�7� �'j ,�.� y r�-���
CONTRACTOR NAME PHONE E-MAIL
I-l�t-��Gp.^.�S;" �-rZcrJ !rr/lvu u—f_ �-lo� _ 5i _ cf I.10 / i�-, c-i� �c i+oLDS-r cu�
STREET ADDRESS CITY, STATE,ZIP
Zo Z S G-rh-r�u�; L: `�rE �?�tS � �-�f 5� G 1� �5'!! d
MAIL CERTIFICATE TO: (Please allow u to 10 business days for deliveiy :
CONTACT NAME PHONE E-MAIL
/a-L� L w � �0 , 7��,_ i.f�01 /�- ��o�D�� c:d=�1
STREET ADDRESS CITY', STA1TE.ZIP ! G C
�L� ��'Tl"'v� ! L. � ! �i �Lv �A-/V �`�SFi - �iir� / 7t��0
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT NUMBER DATE FINALED INSPECTOR SCOPE
i ���T��� �(� . �� t�-�2 � .� 1 15 v
2
3
4
NOTE: Please attach a copy of BOTH SIDES of the signed inspection job card to this application.
- OFFICE USE ONLY-
SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST:
Copy of Job Card Attacl�ed(both sides)?
Permit Signed off in system?
No odier pern�its open or expired in system?
CofO Applicatiort.doc revised 1//27/17
� } CTI1'OF CUPII2'I'I1�0 BLJII,DIIVG PII2M17'INSPF�CITON CARD
BUIL,DL\G ADDRFSS
]01 G I DE ANZA BLVD C�n'TRACI�OR P�M�T.n�
CUPERTINO,CA 95014 HOLDER CONSTRUCTION CC�tOUP LLC &2017-]015
OVVNII2'S N,4n9E
WATERDRq ,CbN 289 LL.0 PO BOX 700742 SAN JOS�CA 95170.0742 PII2IVIIT LSSUED:
OVVNIIZ'S PHONE. 10,'16/2017
PHONENO:
JOB DESCRIpTION:
APPC.�1ST FLCOR T.I.-(12,158 SF)
T�'�'E INSPECTOR DATE
PLUMBING
[II�'DERGROUIJD GAS PIPQJG
UND[RGROUND WATER
UhDERGROUNDSEWER
UIvDERFL,00R
ROUGH PU1��3[NG
SliOWER PA1J
\4'ATER HEATER
N�qTER SER��CE
GAS PRESSURE 7ES'I
GAS ME1�ER RELEASE �
PROPERTY LA'E CLEANOUI�
PLUivIBL�;G FQ�,4L
ELECTRIC4L
t,FER
To.a�.an cE i�s P�ov
u�'�ErtGROUun Call 777-3228 beh�een 7:30 am and 3:30 pm n�londap through Frida},at least 24 hours before required
inspection.Job ad�ess and Permit Numbers are needed�tit�en reques ting an inspecdon.
Ui�'UtRFLCpR
ROUCH ELECTRICAL COPII2TIN0 SA\`ITAR1'DISTRICT
Closed circuit�ideo inspecfion of propert�•line cleanout,point of connection
TE��OR.4Rl'PON'ER POLE and street lateral required prior to passing FL�pL CIT]'pLU�qgLtiG
SERVICE UPGRADE 11�SPDC"IION.Call the District(408-253-7071)for an appointment.
ELECTRIC A4ETER RELEASE NO BUII.DLVGFINAj S L�SPECI'IONS IJt�"I�II.,tu,LR�QUjRID
ELF.C7RIC FQ�AL � BLSLNFSS LICE`�`SES AREOBTAL\ID
n�eCHnNICA[, PFRNII"('F�P[RFS[F���ORKIS NOTSTARTm�1'fi'HIN 180 DA1'S OFPQ2nllT
�'�'�Ea�tmR LSSUANCEOR 180 DAYS FR0�1L.4STCALLID G1SPE]CTIp\. I
aoucEi naEciu�.�.�c.ai
L�IPORTA;\T��'hen a permit has expred,a charge totaling one-half the fees to obtain a ne�s permit
FURN?wCE must be paid in order to reacH�ate the permiL If a permit has been expired for more
than one year,a charge totaling the ful]fees to obtain a newpermit must be Fraid
AIR CO�'DITIONER Yd
to reacti�ate the permit.
HOODS
A�CHAI�9CAL FQvAL NOTFS:
T-BAR
PLLMBP.JG
ELECTICAL '
MECHANICAL
BUILDNG
FIRE
SRT6�LSIING POOL
REMFORCEMETT
PiM/E
ELECTR[CAL BO;JDI!�'G
ROO£[.VG
PRE I1�SPECTION
TLAR OFF
?�.4ILIVG
BATTEVS
T��'E I\'SPECI'OR DATE T1PE I?�SPECTOR DATE T'PE 115PECTOR DA'IE
FOIJ\'DATION PI,U'1�iBI1C S/v\7TARY iNSPECT10tiS
,bTIVGS SHON�ER PA,\ U!�IpERGROUt�D
UFER N'ATER HEATER HYDROFLUSH
PIF.RS U'ATER SER\'ICF.
GRADG BG�S GAS TLST � PUBLIC WORKS �
fGHT OF N'AY
GARAGESLAB GAS METER RELEASE
GROLT'D/SITE NORK GRADITiG
l;'1�'DERGROUND ELECTRICAL ELECI'RICAL RETAINWG N'ALL
U1�'DERGROUND GAS P�[NG TEn4P PO\�'ER POLE
UNDERGROUIvD WATER SERVICE UPGRADE FIRE DEPARTI�IE\T
SITE CO,w'LIANCE
UI�DERGROIR.D SE\VER PV SYSTEM
SITE R'ALLS EV Sl"STEM F«h�'Sl'STEMS ���
FOOTMG F[RE SPRINKt_ERS-ROUGIi;,f�r�t•� ����,1 F
r.i ��:��:�`k'7
MASONRY'REBAR �IECH.4YIG1L FIRt.SPRINKL.ER-h�l.tiAL 'y�:�'`u�'
DRA[�'AGE FI,RN.4NCE F[RE ALAR\1 FINAL � j_,� !��L tV �
CMU�4'ALLS BOII.ER STANDPIPE SYSTEVtS
L�\DE}2FLOOR q1R COt�'DITIO\ER EiiG1NEERED PIRE PROTECTIO\SYSTBM
IP,VDGRFL00R PLUMBAIG
HOODS F[RE LIFC SAFETY �{� 1' �/�
UIJDERFLOOR MECH.4tv'ICAL. " "`-� � I✓ �!J
DUCT N'RAP
U;�DERFLOOR ELECTRICAL DOC'U�IEITA'IIO\
UNDERFLOOR FRM4LVG .�._B� P.�'SE?BACK CERTIFICATIO�!
l,?1DERPLOOR INSUL4TION PLt,n�iBMG �` TRUSSES
��C EL.ECTICAL ��' r SP�.CIAL L1SPtCTlO\'RtPORTS
FLOOR NAfUSHL.4THING
�.�+ MECHANIC,4L SMOKFICARBON MONOXIDE CERT OF
ROUGH PU.�QBLNG -^ �? � COVQ'LL4NCE
Bli'ILDIVG . \'ATER F[XTURE CERT OF CO\qPLWNCE
ROUGH MECHA,\7CA1.
}« ENERGY COMPLIANCE FORMS
ROUGH ELECTRICAL
� � C.4LGREEN�L4NDATORY ITEb1S C}IECKLIST
ROUGH FRA,�ID�IG 't" f c " "'. - i�'
{f _'�? e E � .� Y�.�'�G` ' SwP:1R11ING POOL
11�TERlOR SHFAR 9 � REINFORCEMENT
DEP.�RTME\T FLKALS
EXTERIOR SHEP.R P/�•1�E PLA1�T�1G-CALL 7773305
N'ALL IVSULATIOV ELECTRICAL BODIDING pLIBLIC WORKS-CA1.L 777-3i54
CEfLLNG INSUL4TION DEP10LITIOV F[RE-C4LL 17S-0010
ROOF NA[LING BACKfILL FIE4LTH-CALL 408-918-J400
LITERIOR FL'v7SKES � -
... �j �� i. �„,�-,.Tr SANITARY-CALL 253-7071
SHEETROCK {�',: �Y�� �-�.,a, . �`�.'4 k��fi ROOFLIG
TfLE BACKER UIvDERLAIT M � �'� pRE(NSPECTIO\
BU7LDLIG F'L�ALS -
TILE BACKER TEAR OFF PLUMBL\G ��^�%s` �� X
"� -�",�_��C �� x f��.S
L'�TER10R LATH Npu.WG `"`'S. F ! � ;
ELLCTRIC '�tq..�
EkTERIORFL�ISHES � � -
BATTETS e
EXI'ERIOR LATH T'�CHAI�'ICAL j i^,-.��i ��:_ L . t .
TE?viPORr1AYOCCUPANCY k- i� �,
SCRATCH COAT �
BUILDLNG
S[D[;�G
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