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CITI'OFCLPG,�tTIV013C71LDI�CPERMI"CIVSPCC"CIONCARD -- - - "I
BUILDIa\G ADDILiSS 20600 ST�VG,VS CRL-�GK BLVD CUPF,RTTNO,CA 95014-2120 CO�"1'R��CTOI2 TIANM[NGZHANG 1 LT21191T NO F3-�OU-0479
O\�V�Cl2'S NANIG ByerProperties LP YHONL408-933-3298 PI12��IITISSUEI):OSiIC,/2019
PHONGNO: ADllI2LSS:66 Poitcro Ave San Fiancisco.CA 94103 -
TYPE INSPECTOR DA"fE .IOB DFSCI2IPTIn\: -
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228•buildinq(a�cupertino.orq
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PRO CT ADDRESS ` APN# DATE
Q S�-PJ�'�S 1IN , CUPERTINO, CA '3�� — -0� g �b � �
OWN.RN� M , aQ PHON, E___ ^��^��� E-MAIL
� r y� �I L��' ..N
'1./•
STRE\/ �D R`O�r CIT�S�N+ Z�WS��'V v' { �V�
CONTRACTOR NAME PHONE E-MAIL
Tc t �i� kc 0 - �1 fl`f'q f?�t'`f' �'i a �v h s�'w:�zs� ma i •c.o
STREET ADDR`SS ���`� � �` CI Y, STATE,ZIP �
f\ f_ �)�a'7'1�'f/�
.LJ�P�0 ��N 6 V
MAIL CERTIFICATE TO: (Please allow u to 10 business da s for deliver ):
CONTAC�ME ��y>^ Q� PHON�����`����� E-MAIL,, �� � J„O� + „� ���s •_/
��'��W v '�� r� 1.c
S7REET ADDRESS CIT , STATE,ZIP
�}b G Cr O A. k'• �,�O�r�o�. S`C3'�Z�
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT NUMBER DATE FINALED INSPECTOR SCOPE
1 ��t� ��+� � 3a ' (� T��. -�w,, ���.,-1-
z
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 Attached(both sides)?
Permit signed off in system?
No other permits open or expired in system?
Verification of payment for certification?
CofO Applicataon.doc revised 08/08/l8