15120077 - CofO • �
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This Certificate is issued pursuant to the requirements of Section 111.2 of the 2013 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.
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� Building Permit Number(s): 15120077 Application Date(s): 12-08-2015 Issuance Date(s): 07-29-2016
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I Address of Building: 10095 Saich Way, Unit 1
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� Scope of Work: TENANT IMPROVEMENT (1605 S.F.)
Use: Retail Occupancy: MB �'� Construction Type: V-B
Floor Area: 796 s.f. Occ Load: 18 Fire Sprinklers System: Yes
Current Property Owner: Borelli Investment Company
Current Owner Address: 2051 Junction Ave., Suite 100, San Jose, CA 95131 �� `
� Final Inspection By: Bob Sabich, Building Inspector
! Final Inspection Date: 09-06-2016 ���
*SPECIAL STIPULATIONS OR CONDITIONS: None
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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 place on
the premises, and shall not be removed except by the authority of the Building Official.
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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
CUPERTINO
(408)777-3228•building(a�cupertino.org
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PRO.TECTADDRESS 10095 A Saich Way CUP.�.,RTIN�� �+A � APN# � DATE 7�13/2022
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OWNER NAME PHONE E-MAiL
Asurion UBIF Franchise LLC DBA Asurion Tech Repair&Solutions 817.369.5678 Lauren@Thigbe.com
STREET ADDRESS CiTY, STATE,ZTP Nashvllle,TN 37203
410 11th Avenuc North
CONTRACTOR NAME PHONE &MAIL Lauren@Thigbe.com
Lauren Simer 817.369.5678
STREET ADDRESS CITY, STATE,ZIP
1831 Chapman Ct Aledo TX 76008
MAIL CERTIFICATE TO: Please allow u to 10 business da s for delive
CONTACT NAME Tabetha l�pplegate PHONE 615.483.1269 E-MAIL
tabetha.applegale@asurion.com
STREET ADDRESS g605 S.Yarrow St CITY, STATE,ZIP
Littleton,CO 80128
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 offin system?
No other permits open or expired in system?
Verificarion ofpayment for certification?
CofO Application.doc revised 06/01/20