H16 A5 L2 P11TEMPORARY CERTIFICATE OF OCCUPANCY FORM
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERTSALVADOR, P.E., G.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - buildingtckupertino.org
API :
316-07-049
BB 2017-0519
DATE: 6/26/18
PROJECT
VALUATION $
SITE 1 Apple Park Wa
ADDRESS: PP Y
OWNER'S NAME: us Cam Holdings, LLC
P 9
PHONE #: 408-996-6684
FAX #:
MAILING ADDRESS (if differentfrom site address): 1 Infinite Loop, MS 21-AC2, Cupertino, CA 95014
CONTRACTORIPOINT OF CONTACT:
PHONE #:
Holder Construction Company - Mike Drake
FAX#: 708-204-3230
REFUND - CHECK PAYABLE TO:
MAILING ADDRESS:
Apple Inc.
1 Infinite Loop, MS 21-AC2, Cupertino, CA 95014
TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION
BOND TYPE: ❑ SURETY BOND
MOUNT (1 % VALUATION
CODE
❑CHECK CASH BOND
F BOND: 5K min- 10K max) $ [BLDBONDS]
EDITION: 2010
TCO EXPIRATION
FEE: $329.00/ma
TOTAL FEE: $ [1 TEMPOCC]
DATE (6 MONTHS MAX):
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
H16 A5 L2 P11
1 A
5,750 sf
57
L2
OTHER DEPARTMENT / AGENCY APPROVALS:
anninq
Signature: ...................................................
...... Date:.......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS*
ire
Signature: .........................................................Date:....
-TrubTic
6
❑ APPROVED
❑ APPROVED WITH CONDITIONS°
Works
Signature: .........................................................Date:................
❑ APPROVED
❑ APPROVED WITH CONDITIONS`
Uther:
Signature:.........................................................
Date:.......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS'
*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 en orce nt action.
Owner o Zgt Contractor 6/26/18
............ .4.
Signature:. . ............... Date:...... Signature: .... .......... Date:......................
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 emer encies e
pp (`
Building Official:..... �. � 0� ...Print:............'. C.T �' t' ...........
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
empOccForn&013.doc revised &22117
Wednesday, August 1, 2018 at 2:14:52 PM Pacific Daylight Time
Subject: Fwd: Status of 4LEAF Recommendation for TCO for A5 Level 2, Pod 11, GL 65-66 H16 Bookend
Lab
Date: Wednesday, August 1, 2018 at 1:10:58 PM Pacific Daylight Time
From: Dirk Mattern
To: Albert Salvador
CC: Traci Caton, Chris Fowler
Albert,
The Santa Clara County Fire Department has no objection to granting TCO for the H16
Bookend Lab, A5 Level 2, Pod 11, GL 65-66.
Regards,
Dirk
From: "Traci Caton" <tcaton@41eafinc.com>
To: "Dirk Mattern" <dirk.mattern@sccfd.org>, "Albert Salvador" <AlbertS@cupertino.org>
Cc: "Chris Fowler" <cfowler@41eafinc.com>, "Craig Tole" <ctole@41eafinc.com>, "Mike
Drake" <mdrake@holder.com>, "Todd Turner" <toturner@holder.com>, "Mike Ossei-Antwi"
<mosseiantwi@holder.com>, "Paul Yeomans" <pyeomans@apple.com>, "Bill Keane"
<wkeane@apple.com>, "Sean Hatch" <SeanH@cupertino.org>
Sent: Wednesday, August 1, 2018 10:06:52 AM
Subject: Status of 4LEAF Recommendation for TCO for A5 Level 2, Pod 11, GL 65-66 H16
Bookend Lab
Good morning Albert & Dirk,
Pending SCCFD approval, 4LEAF is ready to recommend TCO for the H16
Bookend Lab, A5 Level 2, Pod 11, GL 65-66.
The Main Building H16 Bookend Lab, Area A5 Level 2, Pod 11, GL 65-66 is
substantially in conformance with approved construction documents & Project
Designers revisions. See the attached full TCO packet for your review.
TCO is pending required approval from Albert Salvador (City of Cupertino
Building Official) and Chief Dirk Mattern (SCCFD) of this TCO as requested by
Contractor / Design Professional (see attached).
OUTSTANDING ITEMS:
• SCCFD Approval.
• Contractor to provide specific TAB report for the fume hoods prior to C of O.
Holder provided a revised TAB report for H16 from Nabco dated 7/26/2018 but
it is not specific to the Fume Hoods as requested.
• Fire Resistant Rated Doors shall be self -closing and latching.
• Need CSD approval of public tie-in prior to C of O. Flow has been verified for
TCO.
• Excluded items from all Milestone inspections will require additional
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