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BLD-2021-0371 - COFO_Koi PalaceCofO 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 CUPERTINO, CA 95014-3255 (408) 777-3228 building@cupertino.org 19369 Stevens Creek Blvd ste 100 316-20-112 01/11/23 408-781-7866 yorkelee@timespacegroup.comKOI PALACE CONTEMPO LLC 19369 Stevens Creek Blvd ste 100 Cupertino, CA 95014 BRI 831-297-0012 project@briconstructions.com 37390 Cedar Blvd Suite C Newark, CA 94560 Sophia Zhang 408-786-8866 SOPHIAZHANG@KOIPALACECONTEMPO.COM 19369 Stevens Creek Blvd ste 100 Cupertino, CA 95014 BLD 2021-0371 1/1/2022 Jasmine Archbold11.22.22 Albert Tenant Improvement - Koi Palace - (3393 SF). None.X X X