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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.orq
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS APN# DATE
21666 Stevens Creek Blvd, Cu ertino CA 95014 4-30-18
0V1'NER NAME PHONE E-NfA1L
Bruce McKinnon 925-314-4233 bmckinnon@ ac izza.com
STRGL-T ADDRESS 220 Porter Drive#100 CITY, STATE,ZIP gp;�
San Ramon, CA 94583
COA'TRACTOR NA\�E PHOn'E E-MAIL
SSW Construction 916-218-2464 msallee@sswconstruction.com
STREET ADDRGSS CITY, STATE,ZIP FAX
804 Reading St., Ste. A Folsoin CA 95630 916-542-7874
MAIL CERTIFICATE TO: (Please allow up to 10 business days for deliveiy):
CONTACT NAME PHONE E-MAIL
Michelle Snell 916-773-9595 x12 msnell@sswconstruction.coin
STREET ADDRESS CITY, STATE,ZIP ppt
804 Reading St.,Ste.A Folsom CA 95630 916-542-7874
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERNIIT SUBMIT ISSUE DATE INSPECTOR SCOPE
NUNIBER DATE DATE FINALED
1 B-2017-0384 2-24=1�7 8-22-17 4-26-18 Gar Stream Tenant Improvement for Pizza Hut
2 -�
3 '
OCCUPANCY DATA:
USE OCCUPANCP TYPE FLOOR AREA OCCUPANT LOAD
1 Commercial B V-B Non-S riril:led 35 42
2
3
4
BUILDING DATA:
#STORIES #STORIES OVERALL DIAX OCCUPANT FIRE SPRINKLERS rIRE SPRINKLERS
BEL01�'GRADE ABOVE GRADE FLOOR AREA LOAD REQUIRED (YES OR NO) PROVIDED (YES OR NO)
N/A 1 1 42 No No
#PARI{1NG #STANDARD/COD�IPACT #ACCESSIBLE
REQUIRED PARKING PROVIDED PARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED
5 35 2 iNSPECTION CARD TO TAIS APPLICATION.
- OFFICE USE ONLY-
SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST:
Copy of Job Card Attached(both sides)? x
Pennit Signed off in system? x
No otl�er pennits open or expired in system?
Location of Approved Office Set?
CofO Applicrrtion.doc revised OS/17/16
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