BLD-2020-1927 - CofOCofO 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
21530 Stevens Creek Blvd.,
FirstElement Fuel, Inc.949-205-5553 accounting@firstelementfuel.com
5281 California Ave.Irvine, CA 92617
FirstElement Fuel, Inc.949-205-5553 accounting@firstelementfuel.com
5281 California Ave.Irvine, CA 92617
941-266-0768 Kimberly.Wilkins@FirstElementFuel.com
660 E. Dyer Rd.Santa Ana, CA 92705
True Zero Attn: Kimberly Wilkins
BLD-2020-1927 11-02-22 Bob Savich Installation of (2) H2 fueling dispensers; Accessory UtilityStructures; Improvements and Landscaping to an ExistingGasoline Station.
357-20-027 11-02-22