15060160 - COFOce
This Certificate is issued pursuant to h Up -en s of S c io 0: alifornia Building Code certifying that
at the time of issuance, ther,portionofth'141iss�cre esc d o a been inspected for compliance with the
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requirements of this code and withthe various ordinances of the I regu a m ildmg construction for the occupancy
and division of1k Vci a�cy:ar d the use `r wh�cfa t t e oposed� o� ancy is classified.
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Building Permit Number(s): 1506016`0 Applications (s).-2�2015 Issuance Date(s): 9-14-2015
Address of Building: 19409 Stevens Creek Blvd., Suit 0 , ,, Pieolog ;
NMI i
Scope of Work: TE NANT�JMPROVEMENT (2,187
�occ.
Use: Restaurant zoccup ncy Classi i at i A-2 Occ Loadgil0 �.
Total Floor Area: 2,187 I I
sq.ft.Type ofConstruction -B .i •e S n klersSystem: Throughout
Current Property Owner: Mai dStr et Cupe�it,"Ii g 'r
Mi
Current Owner Address: 288 Sa d�IillRdSwit 24 I GSA 9 0 5ISM.
Final Inspection By: Gary StreamBurling1sRc
Final Inspection Date: 03-M1 2
SPECIAL STIPULATIONS OR k
ON `IT ONS None
g>
Albert Salvador, P.E., C.B.O., Building Official Date Issued
NOTICE/POSTING No chs ge , sh `t be �►ade n %► °cha�cter' of o cupanc r ce ficaNshaill,e p s e " a conspicuous place on
the premiss, analsha/lnote remold e e y th . uthor . ofn . Qfiicial
CUPERTINO
APPLICATION FOR CERTIFICATE OF OCCUPANCY
OR CERTIFICATE OF COMPLETION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingCci-)cupertino.org
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
'���I699T,evens Creek Blvd, Suite 140
APN316-20-109
I OVERALL
FLOOR AREA
D$%15/16
QF'WEiNAM�
ogyieupertino, LP
FIRE SPRINKLERS
PROVIDED S OR NO
Po -800-8314
E-MAIL
p@pieolo gy.com
STREET ADDRESS
30242 Esperanza
CITY, STATE, ZIP
Rancho Santa Margarita, CA 92688
FAX
949-858-7825
ONTRAC"rOR ME
aN eviewI�'onstrution
icture for the Main Street Cu
PHONE
1262-220-3251
E-MAIL
louis.west@lvconstruction.com
STREET ADDRESSCITY,
10505 Corporate Drive, Suite 200
STATE ZIP
Pleasant Prairie, WI 53158
FAX
262-587-3424
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACT NAME N FMA
Pieology Cupertino, LP - 00-8314 ap pieology.com
STREET ADDRESS C, A, ZIP F
30242 Esperanza RanITYchSToTESanta Margarita, CA 449-858-7825
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE
NUMBER DATE DATE FINALED
1 15060160 6.25.15 9.14.15 12.21.15 Gary Stream —Tenant Improvement
2
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
1 Restaurant Restaurant A2 2,187 SF 106
2
3
4
BUILDING DATA:
# STORIES
BELOW GRADE
# STORIES
ABOVE GRADE
I OVERALL
FLOOR AREA
MAX OCCUPANT
LOAD
FIRE SPRINKLERS
REQUIRED ES OR NO
FIRE SPRINKLERS
PROVIDED S OR NO
0
2
Unknown
Unknown
Y
Y
# PARKING
# STANDARD/COMPACT
# ACCESSIBLE
REQUIRED
PARKING PROVIDED
PARKING PROVIDED
NOTE: ATTACH A COPY OF THE SIGNED
INSPECTION CARD TO THIS APPLICATION.
The public parking str
icture for the Main Street Cu
ertino Development
and on street parking in front of the building serves this facility.
- OFFICE USE ONLY (To be completed by inspector of record) -
SPECIAL STIPULATIONS OR CONDITIONS:
CofO Application. doc revised 05/07/12
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TEMPORARY CERTIFICATE OF OCCUPANCY FORM ,,,ti��
COMMUNITY DEVELOPMENT DEPARTMENT * BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL its ra
10300 TORRE AVENUE * CUPERTINO, CA 950143255 16
CUPERTINO (408) 777-3226 * FAX (408) 777-3333• buildina0cuRertino.oro
APN
T0 #/� �j ro Q
CODE
DA
VALUATION: $
SITE
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ADDRESS:
G'� � YG
tlw
OWNER'
E: /
.
PHONE
X#E#&/,g4;7
41%
�
rA
MAILING ADDRESS (if diff egent fr rfisite address): UU 1,j
dJt
Gam. c. uA11ja5!&C.i�
CONT CT
R:
❑ APPROVED WITH CONDITIONS*
PHON
FAX MEM ,,, - """ �' .3 0`6
CO A
PHONE#:'� -� �7- 336f/
�•
FAX #:
TFMaARARV CERTIFICATE OF OCCUPANCY INFORMATION
BOND TYPE: ❑ SURETY BOND
AMOUNT (1% VALUATION $5100(5 [BLDBONDSj
CODE
❑ CHECK CASH BOND1,OFBOND:
5K min -10K m xEDITION:
COMMENT
TCO EXPIRATION
I/9,1
��
FEE: $286,00/mo
IITEMPOCCj
TOTAL FEE: $ C.
DATE (6 MONTHS MAX):
❑ APPROVED WITH CONDITIONS*
.
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
ire I �� ,� CC.
SinatureYl .%.....% ......5L .................
n +Al
D e....... U.
❑ APPROVED
❑ APPROVED WITH CONDITIONS*
❑ APPROVED
0 APPROVED WITH CONDITIONS -
Signature: .. ...
Si nature:
Date:
Other
Dated : �� i'` J
APPROVED
❑ APPROVED WITH CONDITIONS*
nTur-R nr-PARTMFNT / AGENCY APPROVALS:
Planning
❑ APPROVED
❑ APPROVED WITH CONDITIONS*
Signature: .
Date:
ire I �� ,� CC.
SinatureYl .%.....% ......5L .................
n +Al
D e....... U.
❑ APPROVED
❑ APPROVED WITH CONDITIONS*
❑ APPROVED
0 APPROVED WITH CONDITIONS -
Signature: .. ...
Si nature:
Date:
Other
Dated : �� i'` J
APPROVED
❑ APPROVED WITH CONDITIONS*
Signature: Y ... ......... .... ..
.. . ..
*CONDITIONS'OF COMPLETION - Attach a letter signed by the contractor and owner of the property
stating the list of items required to be completed for each individual Department before final occupancy
can be granted. Include approximate completion dates for each item.
The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or
buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration
date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-compliance
may result in an enforcement action.
Owner Contractor
Si nature: .... Date:�r .-c?).: 1.0
Data: Signature: . ..,Q .. .... .
This temporary certificate ensures that all fire protection and life safety systems have been completed, inspected, successfully tested and
approved for the specific area of the building specified above to provide a reasonable degree of safety to the occupants from fire and
similar emergencies.
BuildingOfficial: ...................................................................... Print ......................................................................... Date: ..............................
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
TenW0ccForm 2013.doc revised 717114