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STAT�. 1 FAX �� 1��S,5 �1 ��,���r� �,p. �°Z �v��Ee�i ru�� �b�- 50�� COVTRACTOR NAME r PHONE E-\1AIL ��L'�t- �t,it��a. `�o�� , 3i� ..S2d STREETADDR�3S? / � �PJ�aG ��` CITY, STAT.�Z�N�`�tS � FAX ��� � {� 1,'1 `� �l S 2� MAIL CERTIFICATE T0: (Please allow Lip to 10 business days for delivery): CONTACT NAME � ^; PIIOtiE G E-\1�f1� 1- �� � ��O ���` �� � �y� � ��., ��%'� STREET ADDRESS � � �� ���_, �,� CITY, STATE.ZI� �� � � � �� FAX �U LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: PERMIT SUBNIIT ISSUE DATE INSPECTOR SCOPE NUMBER DATE DATE FINALED 1 - � 1 _�tU' ? � �7 � 2 �l r -(��i 3 OCCUPANCY DATA: USE OCCUPANCY TYPE FLOOR AREA OCCliPANT LOAD I . £�r'►'i - _! •��:�`: Z S�`' " , . F� 5� 3 4 BUILDING DATA: #STORIES #STORIES OVERALL �1A�OCCliPA\T FIRE SPRI\KLERS FIRE SPRINKLERS BELOVI'GRADE ABOVE GR4DE FLOOR AREA LOAD REQUIRED 1'ES OR NO PRO�'iDED YGS OR\O) 113� - .�. #PARKING #STANDARD/CO�IPACT #ACCESSIBLE REQUIRED PARHI\G PROVIDED PARKI\G PR0�7DEU NOTE: ATTACH A COPY OF THE SICNED INSPECTION CARD TO THIS APPLICATION. - OFFICE US�ONLY- SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST: Copy of Job Card Attachcd(both,idcs)? Permit Signed off in system'? No other permits open or espired in system'? Location of Approved Office Set? Co/OApplicntion.doc revised OS/l7/16 CI"Il'OF C[,P'r72TIN0 BL7LDL�G P F12NI(T I�S PFl"I'ION CA}2D BLIILDING ADDRFSS 10815 W OLFE RD CUPERTINO,CA 95014 C0ITRACCOR CiQLD MEDAL.LiGN II��C PII21�ll1'NO&'017-1143 OVV�'IIt'S NA!1�IE CUPERTINO V[I.I_AGE LP _ PHONE PFR.�'Q"f ISSUFI):03/07 2018 PHO\�NO: ADDRESS:3333 NF��'H`i`L�E PARK RIJ K I W STE 102 NE\��HYDE PARK iv�'1 I(Y�2 TlTE INSPECTOR DATL �OB DFSCRIPTION: ' Fo[r.vv.a�novSITE���o�uc CRFAMISTRY-T.L-(11;8SP) F'OL�.''�DATION #�V� ! ' �"'��Ct`-s'i"�%Ys:F_�� (�x.�L.C- g�` F`��-i�L'"" 1�'.;��k,��' UFER QtOUND �C4-�/�[(Tit?.-�e::��t.�.��5" '�-���..T. 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