12070195 - COFO • •
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This Certificate is issued pursua td,--_there uirements of Sect on61 TOW of the 0 O California Building Code certifying that
at the time of issuance, the ortrontofirhis sfruct re described below has eenAn ted for compliance with the
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requirements of this code and with,theRUMbus ordinances of thd�G ty regulating�build onstruction for the occupancy
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and division ofoccupancy and the use for wiich tfe--proposeoccpany is classified.
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Building Permit Number(s): 12070195 'ApplicationDate(s)X07-242b12 Issuance Date(s): 12-04-2014
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Address of Building: 21530 Stevens Creek Blvd w
Scope of Work: CHANGEI S
" E� GAS SERVICF—STAT#ON TOR AIL STORE.
( ` � S.F)F.)ANAMPROVEMK15: 7-ELEVEN
ADDTION. � T `
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Use: Retail
Vic, y Classification M / B
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7ccupant Load 48 occ.
Total Floor Area: 2,279 sq ft7. pe of#Construction V B F e Sprinklers System: Throughout
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Current Property Owner: BS
MgCupertino Union
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Current Owner Address: 21530 Steve sCreek lud °Cuprt�no 9501 }
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Final Inspection By: BobSab chu�ldinglnspector ,
Final Inspection Date: 02-16 2016
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*SPECIAL STIPULATIONS OR C§ONDITt�NS. ENone - �` �4
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Albert Salvador P.E. C B.0 Building Official Date Issued
All V i2 4 NO
NOTICE/POSTING Nohanges shy//be made the<cha c#erg of a�ccancy Tis cMAM
etcate s� °e posted to as conspicuous place on
.1the�prem� es, and shat not be + roved except y the zuthontj of#tie Buy ng Official ay
• •
APPLICATION FOR CERTIFICATE OF OCCUPANCY
OR CERTIFICATE OF COMPLETION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•building acupertino.orq
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS'J t 5--t) .�/���,\� � � 1 APN# ���_2L _C)1-7
OWNER NAME Lf J / J I`W PHONE� o `�V J I¢ E-MAIL
uv C K �� � '4U
STREET ADDRESS OC� ' ` CITY, STATE,ZIP (^I r \u,a ��/ FAX
CONTRACTOR NAME Jam, _ �V 1 PHONES lo` �] 1/ , �J(�J E-MAIL
STREET ADDRESS/ n L) �}1 CITY,STATE,ZIP `7J J i j 2- FAX ----
460 Q0
MAIL CERTIFICATE TO: Please allow up to 10 business days for delivery):
CONTACT NAME`lam ! PHONE/jE-MAIL
STREET ADDRESSz, `� CITY, STATE,ZIP in,/�� FAX
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LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE
NUMBER DATE DATE FINALED
1 7 12L411YCO&Waj i s ACl L r
2
3
OCCUPANCY DATA:
USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD
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2
3
4
BUILDING DATA:
#STORIES #STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRINKLERS
BELOW GRADE ABOVE GRADE FLOOR AREA LOAD REQUIRED YES OR O PROVIDED YES OR NO
-09
#PARKING #STANDARD/COMPACT #ACCESSIBLE
REQUIRED PARKING PROVIDED PARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED
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25 1 INSPECTION CARD TO THIS APPLICATION.
- OFFICE USE ONLY(To be completed by inspector of record)-
SPECIAL STIPULATIONS OR CONDITIONS:
Cq)'O Application.doc revised 0510772
CITY OF CUPERTINO BUILDING PERMIT.INSPECTION CARD
BUILDING ArDDRESS CONTRACTOR:SAGARCHI I30.:1 (}7Qj'95s'
` ENTERPRISES INC
OWNER'S NAME:BSA CUPERTINO UNION LLC 495 E BROKAW RD#F DATE ISSUED: 12/04/2014
owNF,R'S PHONE:4083169386 SAN JOSE,CA 95112 PHONE NO: (408)458-6670
TNST'ECII10 'xw•
INSPECTION
FOUNDATION/PIERS/H.D.S. 4 BUILDING PERMIT INFO: BLDG ELECTPLUMB r MECH r
UFER GROUND ;s *-
RESIDENTIAL I COMMERCIAL f—
YAD/SET BACK-CERT JOB DESCRIPTION; TENANT IMPROVEMENT (1624 SQ FT) WITH A 634 SQ FT
GARAGE LABSr REGUNITE
DITION TO AN EXISTING GAS SERVICE STATION.
Pt�llRN CONCRE`TEt I.L '#'ES:B l:D; ?.
UNDERGROUND/SLAB
UNDERGROUND PLUMBING »<,
UNDERGROUND ELECTRICAL
DO.NOTPOTJRILOOR.;TINTII,"A�B� =HASBEEN:STGPIED'' -
UNDERFLOOR PLUMBING
.UNDERFLOOR MECHANICAL
uNDERFI.C)C�R ELECTRICAL WILDLAND URBAN INTERFACE FIRE AREA ER#
UNDERFLOOR FRAMING VENTS
UNDERFLOOR INSULATION TO ARRANGE INSPECTION
Ca, 777 3 28 between T;30 aT0 v 3:30 pm it'I0n'd, y;thrauph Fri`tlay,at least Z4 hours
PLACINO$TJhFLOORU TITNA$4h' `'klASB EN;SIGNED before required inspection.Job address and Permit Numbers are needed when
ROOF SHEATHING £A requesting an inspection.
ROUGH PLUMBING
CUPERTINO SANITARY DISTRICT
TUBS&SHOWER PAN Closed circuit video inspection of property line cleanout,point of connection
ROUGH MECHANICAL
Rand street lateral required prior to passing FINAL CITY PLUMBING
OUGH ELECTRICALTOOL BOND
INSPECTION. Call the District(408-253-7071)for an appointment.
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FRAMING/5TAIRS/E.EGRESS NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
INSULATION%VENTILATION BUSINESS LICENSES ARE OBTAINED
ar-
EXTERNowEARMOLrIDOWN PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT
EXTERIOR SHEAR/HOLD DOWN !� r0
ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION.
'INTERIOR SHEAR/IIOLD DOWN
SHEETROCKr'SHEETROCKSREAR � 5 IMPORTANT
Ex'rERIOR LATHrw-SCREED When a permit has expired,a charge totaling one-half the fees to obtain a new permit
A must be paid in order to reactivate the permit.If a permit has been expired for more
INTERIOR tA'rx than one year,a charge totaling the full fees to obtain a new permit must be paid
NO TAPE OR PI.ASTER.UNTIIFiJBO4?ETfAS.13E1 NSti1D ® to reactivate the per p
SCRATCH COAT (01Tt-
t {C�I�Y Or �dj• '_ - �V/ rSF.WER/WATER
T-BAR/MECH/ELECTABO �i..I9 S �' a t�
FINALS •/d•/'"' .+ {�y '- ✓<S S .
ELECTRIC METER RELEASE SPECIAL INSPECTIONS Inspector: Date:
GAS TEST/METER RELEASE
GRADE-PUBLIC WORKS ROOF INSPECTIONS
PRE-IN+NSSPATION:Inspector: Date:
-DIRE-CALL(408)378-4M
408)378-401 _ ( -
AR-OFF. Inspector: Date:
PZANNINU(408)777-3308
PLYWOOD: Inspector:_ Data:
SANITARY{408)253-707 t /
ELECTTRICAL BATTENS: Inspector: Date:
MECHANICAL IN PROGRESS: Inspector: Date:
PLUMBING FINAL: Inspector: Date:
HANDICAP NOTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION.
ENERGY
*OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY
•BUILDING INSPECTOR
CERTIFICATE OF OCCUPANCY• L� `�} -tee ! 4 ��y g`a � ::�
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CITY OF CUPERTINO BUILDING PERMIT INSPECTION CARD
BUILDING ADDRESS:21530 STEVENS CREEK BLVD CONTRACTOR:DC ELECTRIC PERMIT No 14100132
OWNER'S NAME:BSP CUPERTINO UNION LLC 405 RING NECK LN
OWNER'S PHONE:4086744064 DATE ISSUED: 10/22/2014
SUISUN CITY,CA 94585 PHONE NO: MIJ 386-2117
FOUNDATION/PIERS/H.D.S. BUILDING PERMIT INFO: BLDG ELECT r PLUMB r MECH r
UFER GROUND
RESIDENTIAL r COMMERCIAL r
PAD/SET BACK CERT JOB DESCRIPTION: INSTALL CIRCUIT TO POUTER MOBILE TEMP POWER
GARAGE SLABS/PREGUNITE
PUUR NU CO, ?E:UNTII;ABO: .BAS:$E ia'SI D-g .
UNDERGROUND/SLAB
UNDERGROUND PLUMBING
UNDERGROUND ELECTRICAL
DO NOTPOIIRFIUO$IJhI ^ S$0�i: S.BEENSIGII1_
UNDERFLOOR PLUMBING
UNDERFLOOR MECHANICAL
UNDERFLOOR ELECTRICAL WILDLAND URBAN INTERFACE FIRE AREA r ER#
UNDERFLOOR FRAMING VENTS
UNDERFLOOR INSULATION TO ARRANGE INSPECTION
Call 777-3228 between 7:30 am and 3:30 pm Monday through Friday,at least 24 hours
PLACENOSUBII 1tUNTI1„A1�D;, : sulFNSIGN$p:, before required inspection.Job address and Permit Numbers are needed when
ROOF SHEATHING requesting an inspection.
ROUGH PLiIMBING
TUBS&SHOwER PAN CUPERTINO SANITARY DISTRICT
Closed circuit video inspection of property line cleanout,point of connection
ROUGH MECHANICAL and street lateral required prior to passing FINAL CITY PLUMBING
DOUGH ELECTRICAL/POOLBOND INSPECTION. Call the District(408-253-7071)for an appointment.
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,� r
I RFZMING/STMAI RS/E.EGRESS NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
[NOA
TION/VENTILATION BUSINESS LICENSES ARE OBTAINED
NO W+ARK UNTIL A6f2I 1`I SI A PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT
IOR SHEAR/HOLD DOWN
ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION.
OR SHEAR/HOLD DOWN
OCK/SHEETROCK SHEAR IMPORTANT
OR LATH/W-SCREED When a permit has expired,a charge totaling one-half the fees to obtain a new permit
must be paid in order to reactivate the permit.If a permit has been expired for more
OR LATH than one year,a charge totaling the full fees to obtain a new permit must be paid
E OIt P TERItNTII :' OYE . $EEN,.SI,GNEDto reactivate the permit.
SCRATCH COAT
SE WER/WATER NOTES:
T-BAR/MECH/ELECT ABOVE CEIL
FINALS
ELECTRIC METER RELEASE SPECIAL INSPECTIONS Inspector: Date:.
GAS TEST/METER RELEASE
GRADE-PUBLIC WORKS ROOF INSPECTIONS
PRE-INSPECTION:Inspector: Date:
FIRE–CALL(408)378-4010 —
TEAR-OFF. Inspector: Date:
PLANNING(408)777.3308
PLYWOOD; Inspector; Date:
SANITARY(408)253-7071
ELECTTRICAL BATTENS: Inspector Date:
MECHANICAL IN PROGRESS: Inspector:
Date:
PLUMBING FINAL: Inspector: Date:
HANDICAP NOTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR,INSPECTION.
ENERGY
*OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY
BUILDING INSPECTOR
CERTIFICATE OF OCCUPANCY+