BLD-2021-1172 - CofOCertificate of Occupancy
This Certificate is issued pursuant to the requirements of Section 111.2 of the 2019 California Building Code certifying that
at the time of issuance, the portion of this structure described below has been inspected for compliance with the
requirements of this code and with the various ordinances of the City regulating building construction for the occupancy
and division of occupancy and the use for which the proposed occupancy is classified.
Building Permit Number(s): BLD-2021-1172 Application Date(s): 06-18-2021 Issuance Date(s): 08/04/2021
Address of Building: 19900 Stevens Creek Blvd., Suite 300
Scope of Work: TENANT IMPROVEMENT (6,896 S.F.) FOR NEW DANCE STUDIO
Use: Dance Instruction Occ Class: B Total Occ Load: 174 Occ.
Total Floor Area: 6,896 sq.ft. Constr. Type: V-B Fire Sprinklers System: Throughout
Current Property Owner: 19900 Stevens Creek LLC
Current Owner Address: 800 West 6th Street, Suite 600, Los Angeles, CA 90017
Final Inspection By: Paul O’Sullivan, Senior Building Inspector
Final Inspection Date: 9-29-2021
*SPECIAL STIPULATIONS OR CONDITIONS: None
____________________________________ 10/12/2021
Albert Salvador, P.E., C.B.O., Building Official Date Issued
NOTICE/POSTING: No changes shall be made in the character of occupancy. This certificate shall be posted in a conspicuous p lace on
the premises, and shall not be removed except by the authority of the Building Official.
CofO Application.doc revised 06/01/20
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS CUPERTINO, CA APN # DATE
OWNER NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP
CONTRACTOR NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACT NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT NUMBER DATE FINALED INSPECTOR SCOPE
1
2
3
4
- OFFICE USE ONLY -
SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST:
Permit signed off in system? ________
No other permits open or expired in system? ________
Verification of payment for certification? ________
APPLICATION FOR CERTIFICATE OF OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • building@cupertino.org