BLD-2020-0501 - CofO
Certificate of Occupancy
This Certificate is issued pursuant to the requirements of Section 111.2 of the 2019 California Building Code certifying that
at the time of issuance, the portion of this structure described below has been inspected for compliance with the
requirements of this code and with the various ordinances of the City regulating building construction for the occupancy
and division of occupancy and the use for which the proposed occupancy is classified.
Building Permit Number(s): BLD-2020-0501 Application Date(s): 03-20-2020 Issuance Date(s): 02-19-2021
Address of Building: 10815 N. Wolfe Rd., Suite 104
Scope of Work: TENANT IMPROVEMENT (1,725 S.F.)
Use: Restaurant Occ Class: A-2 Total Occ Load: 87 Occ.
Bldg Area: 15,790 sq.ft. Constr. Type: II-B Fire Sprinklers System: Throughout
Current Property Owner: Cupertino Village LP
Current Owner Address: 3333 New Hyde Park Rd, Suite 100, New Hyde Park, NY 11042
Final Inspection By: James Lee, Building Inspector
Final Inspection Date: 8-12-2021
*SPECIAL STIPULATIONS OR CONDITIONS: None
____________________________________ 11/15/2021
Albert Salvador, P.E., C.B.O., Building Official Date Issued
NOTICE/POSTING: No changes shall be made in the character of occupancy. This certificate shall be posted in a conspicuous place on
the premises, and shall not be removed except by the authority of the Building Official.
CofO 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
CUPERTINO
10300 TORRE AVE
CUPERTINO, CA 95014
Receipt No.:279203
Receipt Date:11/12/2021
R E C E I P T
RECORD & PAYER INFORMATION
Record ID:
Record Type:
BLD-2020-0501
Commercial Alteration
Property Address:10815 N WOLFE RD, STE# 104, CUPERTINO, CA 95014
Description of Work:HIRO NORI CRAFT RAMEN T.I. - (1725 SF) Install Type I Kitchen Hood, Rooftop Equipment,
Commercial Kitchen Equipment; Modify rough-in gas line, sewer line, domestic water line, and
electrical line; Install dining furnitures, ADA service counter, and ADA seating
Payer:Ayumi Sakata
Applicant:Ayumi Sakata
CUPERTINO, CA
PAYMENT DETAIL
AmountCommentsCashierReferencePayment MethodDate
11/12/2021 Credit Card PUBLICUSER347
751
$443.00
FEE DETAIL
Fee Description Invoice #Quantity Fee Amount Current Paid
1.00 $443.00Occupancy - Certificate of Occupancy/Completion 58160 $443.00
$443.00$443.00
AA_Receipt_Template.rpt Print Date: 11/12/2021 Page 1