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APPL[CAT[QN FQFi CERT[F�CATE OF C3CCUPANCY '` OR CERTIFlCATE �F C011tlPLETEON COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CU�'ERTINC7 ALBERT SALVADOR, P.E., C.B.U., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO: CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildinaia'�cupertino.orq COMPLETE A SEPAILSTE APPLICATIOI�T FOR EACH BUILDlIvTG: PROJECT.4DllRESS � C1� /�� c�� �,��^/Q���� ,�p*� /5 �v(� //� I DATE /, I ��p `�I � Ys Y V vV'kJl l T ! O\�'�ER_\Ai�1E �"'- � PHO\� ��^U E-�L41L __ J O�JZc'fU �.i� ' e Sf5 -- �� __ ¢°�` ��-G ��� STREE'I ADDRESS CSTI', ST.-1TE ZIP F,�a �cT o N � ��� � 2�;� Cu .�.rvt C� ����14 CO'�TR4C;OR�A�IE �(t��„ I PH�'��� ����� ���5� E\ZAIL [� ` kf; C�vYtr:t�JQ(^'C'j Y'G(�l'I1 s �t°(�'1 STREEI'��DDRESS � ' CITY', S?.ATE,ZIP p�� p.a,� ��z�l G511% Gtz �S� �.� �G r��GS C� ��'"�� I�-1AIL CERTIFICATE TO: (Please allow up to 10 business aays for delivery): CO'�'IACT\.4A1E %� l / T��r PHO\'E� , j C E-\ZqIL _ �r� ^ � ���� - ' - 1 ����' ?.��. � �� , �j���� C �--�1y� � .-�s ,, C��� —T — STREET ADDRESS / (� � GT1', ST.4TE,ZIP(1 g,�a l ��'CL� ��Ut� /V�' �%(� •Jt- Ui` e� D �kt-x �V��f�C� �/ `' �`�'C� � "l ?:3 1 �.5G5- LIST ALL BUILDING PERiVIITS ISSUED FOR PROJECT: PER'�1IT SUB!!'IIT ISSL'E D�TE i 1NSPEC'rOR SCOPE ?�TiI'17BER_�_DATE DATE FINALED ' _ 1 ,7. �,C�/ ( C( � L' ,Zc/ �—,�—, -/ �� ��_ . � 7� ���5.�_��� .�V�l l7/Z�I/�i�L(Gvli��� ��GI(i1rG l'V� ". Z �--- 7 3 ---�— - -i --- — ------- OCCUPAi�TCY DATA: liSE OCCUPANCY T�'PE PLOOR AREa OCCUPANT LOAD 1 �rr��i,t ��� '(� � _ � _Z � � 6 G 3.S� .-- /3 f , - - 3 4 BUILDII�TG DATA: #ST012IES �STORIES i O��E.RaLL ?�1AY OCCliP.�.\'I' FIRE SPRI\KLERS FIRE SPRInKLERS BELO\V GR�DE ABO�"E:GR4U1�: FLOOR AREA LOAD REQliIRED (1'�S OR�O) PR0�7DED (1'ES OR NO) C� L,�---�-�, ;6 3 5 t l 3 ( � `c�s _ �P.AI2KI:�G #ST?,,'�'DARD/CO!1IPACT m ACCESSIBL� REQUIRED P.-uzhI1G PRo�1DED PaRK1\G PROVIDED .�OTE: ATTACH A COPY OF THE SIGti'ED INSPECTION CARD TO THIS APPLICATION. - OFFICE USE O\LY- SPECIAL STIPULATIONS OR CONDITIOI�rS: CHECI�LIST: Copy of Job Card Attached(Uoth sides)? Pennit Siened offin svstem? ?�'o otlier pennits open or ezpu ed u�system? Location of.Approved Office Set? CofO Application.doc rerised 0�/17/16 ,�- f��� ��,r� CI"tY OF CLP�21'IN�BiJII.DING Pr1LVIIT INSPECI"ION CARP, ----, ,.��.tl .!`'t`rCAllillRESS �.U"',;:-"' �— ---� �2C5?�';;fOIv11�'I7-F,P,I<D �`'� CON'I'IL\CTOR �PII2t�II'f VO i jr U�'rFTL��O,G4 95C14-b302 K1TAVi[ �ISi00119 i �O�'N�2.'S i1A1�IE ---- � — — --i I�UBTLATO L�T�ECTS 1 FTAL 10600 N DEAtiZA B,'.VD L,ivl I'200 C[JPIIZTIIvO,CA 95014 PFRtYII'I'ISSUFD: iUVdN,�12'S PHO�TE __ --- PHONF:NO: � , JOB DESCRIP"i 10\: -1 � __ YAYOI-T.L TO COM}?L:�STE 20682&STE 20684 TO CRF.�TE(':d)RESTAURAi�IT(2,663 SF.) i �� TT'PE i L�SPECTGR � DATE ;� —� t�—�_ : PLU:�iEtLYG�--�— � ;i �--- �LJ.�DFR� C3201/2�C'vLS PIPLtiG _ � � il i f--- � � iL'I�TLRG'ROUIVD W,�TER i II—_� r _� �:u��c�t�,�ro s�;za � ' s ' � �--— R ;�a� � - _� �,.., 4������ � ; �/( �� �i � � � ,� �� , ,.._ ��� � ixot;cr rLv��;G I .:.� {.e i ,A � r., l � J a 1-�� J ���tt j 1� t ; \ I���: 4 � �ti � 1 � t � , � � _______ ; �_� ? ;isx�,v��,�, � - i = � I , , r_ _ _ �i�1AT:12 F;FATER � � i , i I � IY�-- � i —� j�V.'.4'1:A SF:ctV!i'8 I i �!— �{---- ��Gr�d PReSSL;RE7CST � � '-�s�'+� �., ' -�. : il-- — — ,—� �IG.aS.NETF.Ti R�.ZF.'��F. � ��'` �; ��}.�i�_ ; , i`— ----�_ � _ ' � � .� i I�r"�(OPe.kIYLI�F.C[:EAi�G[':' � ! i I �____—_--_'— � � (�i'LL"�i4IVG E'1`AL ! I i�_ ._�_ LL[CI'FICe'L�-- �� —j i �� Ii`�^�� � ' TO AI2R.hN(�,INSDT�CION i �----- ----------I-----' ` I �' t �— i Call 777-3228 beri�c�en 7:30 am and3:30 pm i�foncaay through Friday,at least 24 hours�fore reyuired ��ERI.?'iO1;�D i ii---- ----�-----�— i iaspection.Jeuad�ess andPernvt\Tumtrers are neede�«}�en requesting an insperfion. iiUrtD�SCFLCtiR i i ��---_� __—.��_ � ' i CUPER'I'L\OS.�\TI'ARYDISTRICI' i 'Rc w��cra:c.v_ � � , '1 i �i —._�.__ _. l:.czseceircuit�ideoinspectionefpropertyl'snecleanout,pointofconnection ( �iTF�aUG�ZattYi���a'c1;P�iLF: � i� . J aud,ir:�etlateralrequiredpr�ortopacsiagFZYAI,CTI'YPLUbIBL\G ��—'� — ---'-; �i----;� f,Y„f'-�I'i��N.Call the Bisvict(408-2�3-i�%1)for ar,a�ointment j �fStT Vl:,F,UPi N�r. i i � __ ._ '_—'_�_-- _ ——�1 �It.-�.c'r�1r�u�r�.act FasE i�,.` �- 'p, �,_; ; ;I ti0 BL'ILDINGFL�ALS INSPF.C"I'IO\5 L;�iTL:1LS.F2T�L'II2ID ;�— �_�_�.__ , _ --- -�� BUSL1"FSSLICE�S�.�REOBT�IP�ID `�ecrtu.�f;,;ti, i j i i_ � � jl � r,tEcr^.an�C.a[. � � ;� PE�:i11T Ei'PIRES IF�?'ORKIS tiOTSTARTEDV6'ITI�1'180 DAYS OFPFl2�IIT il'----- -- ; �iunt,Fr,�teGK i ' � LSSti:�:tiCEG�R 180 DAYS FRO�iLASTC.�.i.i.ID L�SYEf't"ION, ! � i s ��?�z;F[�tFCNa�1CP� � � � ! IMPORT.�,�\"I'�;�i:en a pernut has espred a cha;ge tetaling one-half the fees to ahtain a newnerrrdt i ;ir•�R��,��` --�- must be�xud ia ar3zr to reacti�ate�he�ermiG Ii a permit hac beer.e:s�aredfo;nwre � _b ; ` � �� t}.an one-ear,a charge totalina the full fees tc o',�tain a newper:nit r�ust be Qaid � ��--- -- ,i y�.• , I�tir;�cotvma�u-t --r--- � � to reacd�at2 the permit �--------------r--- I;.�cx�,s � � - ---------�---- � �,�T r,;.�:�[ca� �ar ;� �10T�: �, � i�"�� �d� �.�_m.�Y��'ar.�c' �+.�.*� - -- j �- ----_T�,K _----I-- �- - ;I ,' _ ��� I ?- ;� _�p ����-_-� ;ti �_'�:�•..� _�` +;�� -y'� i ���_��,�sr,�: ------- —t � `I ` � j------------ , ;t�:�cr�c;.i.- --____— —i--- �I �i�4t•�F�.�,�,Z�a �--- i � ��-------------�-----�— '� I tir�.,ll.i)f\'G � I ��---_--------___.-t-;,=--- ' -� � ,�, '-- -- ----- _--� ' � � � �� ; =5�.,.��,U��. _�; !;��.�,�,�>��-.T„ ! �- �� �i�<•.vE--------- --� --�-------�---�; I ;� ` i i II I j�------ -----r— ---t--- --+. I i���s�i�;c:.a.ac,�e��c ; I il � ��— ---- rcx3�:;G---i -- +----I; � !�---_.�.:__ __—�.�_--f—_ i i i:z. n�x.'�'.: 1 f —I I .2c I*'S UN � �� : °� � ---�� i I;:rt�«,�rF---------i---j—-- , ;�——----------- --�--- ' i{ � ii>�',`,.'; j � i �i------ - --- —�-- --, ( �.F3ATT��c i � i � � � __ �h'� II�SPECTOR , D�'(� � 'iYP� INSFECTOR DATE TYPE L\SPEGTOR DATF, FOL�DATIpr �.J� --' PJ C'1SBL1G � S.1\TT4kY Ltit�ECTIO\S ; - --{—— ---- - r�OC'I�GS I ------�i ----�-- ... �--- i -i �� ----- SHOR'ER PA\ ( , 'LNDER('�i0i1�D , i -' 3- I, ——i---�----`� I _ �,� � �La-�t � i � T—� � � ! � �iIWATERHEATER i I i;3YDROFL�S4 I I i�PIERS �- i�WATER SERVICE �-�-� � --�--J�{I lrC�RADEBE�U.S --�--�- I -��GASi'EST I -j �- �. PL$LICR'ORKS � '--- ! (' ��---i Cv�R,�Gc SL.AB ��-�� ��RIGf?'I OF WAY i----; � i ;�G.L��.TER RELEASE I I GROL'A'D/STTF FVORK � �-�: . ��QiADL\G I I, I � j- -- �---r- U1DEY,'',�tOL�'D ELECTRICAL � I ��''; � � � I �� ' i L . ELEGfiRIGL � �REL.4L\?':G WALL I I �U1�ERQtOL!��JAS YIPLIG ; ; li;' � i �--� � ;IEJiP PO\4'FR POLE ! � �� I I --t- �' � �f�1DERril20[,\D':.'A'i�2 �II ScRV7CE L'PGR4DE � I�. FIItE D��1RC�SE\1' �- i � 1 I T I , i ..- �SITE CO�fPL[A.\CE I ' ��U;vDtRC�20L�'C CEWcR ' ! I;PV SYSTE�f ; I - . f i � - I ���-- --t-�' �-� � �.1'E�i'41..LS T---� ' i FII2E MAL�SYSTE�LS I ---�-j- .,EV SYSTE.1 � I � Foar��u�---- � - L il�— -I�e�sr��a eRs-�oL��",3.- " �I �-- ,�-� � �� ; � ; ,� j. iviA50\RY RE6.-�R I i '� 11ECH.1:�G�1L � ��FRE SPRL`7Q.ER-FII�AL� �/ J° I IiDR�..'�AGE � -�� - t (!`4� _ i i ; I'FliR�iA\CE � � I� i I � I FIItE ALAIL�f cII�P1, j��9;� �S � � � i - I �={ I�Cf >P VAiLS ----� I�BOLEI2 �S'C,�.VDFIPE SYST&�fS � � i --! _� il.-�: Li\DEP.I7..OGR -r---� � - - i il A[R CD\'DITIO\'�2 I I j E�GL`'EtRED FIItE PRCY[E.CTIOv S'iSTE�f j �U'�� �UEf2FLOOR PLL�II�'Ci ��� f -�--a--�� -- � - � � f-- -r-- �---1)HOCA, � FIRE L�E S.P�.'TY I . f :�3 i i u:�mF�a�r.�c�n��c,at I I —;-----�— �I a`� !,-!—��= n {r i_.--�—�{�n�cr�va,�e ! � I , , IiIJ�DEK:=LOOR EL`cCTRIC�L, � ! `� --1 �-T-�` � i I � i DCL"C11E:�TATION I � —�— ; �� _� I U.V;ERI=L'JGR FRA��fCVG - � � � . 1.B� -�----t--�PAD!S�BACiC C:RTIFICATION I I � 71� ��-- �-T---{I I`LJ�T7E[cFLQ�F.LNSt,�.ATIO\ + I I�PLL'�iBP.�G �;���l.1 �e� ;.L"}�r 9 ��TRI�SSES -r i ( ; I I F --'�`� IY F�';��G i ���h'LSCI'iC��L 'n ,'A�I '-� ' SPEC,"G'�L.[NSPtC;TON REPORTS i-i I IIFLCbR VAILSHEAi HTG � �--�-- -i- J �� ---� � I�CH.��TG1L I ! I S�10KE"C.1RB('iv\fC)\OXIDE CII2T OF I �-- I � CO��LiA\CE I � � FOi,Y`iHPLL'of3L�G i � t: -�- -- - -- � ! ��EOL;�3'vIECrGI�iCA ( � �f BLTLDL�G � �.��WATFA F0.'TURE CFRT_OF COMPL,[ANCE � i � T- ! --------`--�-�- i�FIItE � ��E7�'E O LI.�\CE FOR�1S i -'F� RO' rr�Q��:TRICAL ' - i �� � � � -�,,.�, ; 5 j , � !CALGREEV\tA\'JATOR`i 1TEMS CFiEC[Q':ST j Rnl�Chi FR3�fL�i � '�e..�. ! � -�- � � i I ij— — ==� � �: �"" s���mn�crooL —i --�----i� —�����, -�— � i ii�TiRIGR SkI4'�,}� �Y� il RII�'FORCE�fE\T ._._I- iF' ---. . �� �-_J�_ DEPAR'C��'YC FLT�i�IS ��_-- i--I ��}X:t�:02 SF?PAR i � �P;\,tit i � T+-'-� ..---_--_-.--- : i � 'iFL4.\ti'L\G-CALL777-3308 � � iiWA::.IV5li1.AT.IOti -t � jELE..�'I'RICAC.BO\-DL\G i : r-- -+ --�- I � I �PLBllC'�VORKS-CALI.777 33�4 - - � � (IC�_L.'vG 1\SLq 1T?O;J-�--r� ��D�1,fOL1TIO�i - --r-- - -- I i � j �PiA.E-�,aLL 378�1O10' j ��v•'a i d 'r � r - -?___.-�-y ��`- _ ,__.�I ) 1 $ i�-! !IAOOt:tiAlt!\Ci ' BACKFQ_L. i I - �- i i _�_ I HEALTH-CALL 408-9;8-3400 �ti� (� LrT.F10RFC�SI:ES �- j --I Ii ----� �Ii ' � ISA\`TI'ARl'-CAL.L'�3-707] I I � CHEEiRCCiC .� �� ; � , �I� - .==��=��t.ld.... � BpOFCiG �----�- ,�--- . 11;II.ti.BACHI:k i;�:II)En:aYl�fEi�TI'� I I'PRE L\'SPECTIO\ � �I. � � � I�- -- ---�--- i �I � --- i BC'Q.DING FL'�:�LS � i T�.LE SnCiiER i � - I I{TFA.R OFF i � ' . .#.l I,; � .�� � -�--_�� -t'_- �PLL'MBL\v ' �r--y 3 ��p r �y�� �?viE{I7IOP.IATH � �� ; � //�� � g ��'vrULA:G � �IEi ECTRiC,4L kF`�'"I/�-y.. ,A�I ��__EXI'ERIUR rl:w7,il�ES �}--1� �- �-�~ ---- ' —�dI�BATTE[iS ' I j�?�;LC.'-IA\1C?.L �, ��" �� J� l jIE:'rL4iGRL4TH I � I li• ----�------�_.__��_ yy/�+I�.s�,.� �e r..J�-�A jr---- —�- T—III i j IITE�4'OR4RY OCC7 Pr�.uCY / I �i .RATCH CUA.'I' I � i� — ----t---TT--i' ��'V i ��� 1'�-� ..—. � — f �BLTLDL\G %- -�.'� ;s��.:: �-- i il�- - --1-- 1i i'�`, ��� ,` ��_--_--_—_--- � --�it— -----_'=-�� — � — ' --i ���V�t����C.�11�--C,�iu���1�� ll�l����_ �i���l�'� ��y�„t�T � �C�� �(� t�H�'at:� [i�i��.�� C-�N. �e'��C.'�'�tN��� �i� i���`�� �,r� ���� � ;�r f! ^ �--r� • �', j �� �(r;�—��, ;;� �,, -r`�'�� 1 , ,.� �� ,�' j�—,�' . . 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