H21 A4 L2 P1TEMPORARY CERTIFICATE OF OCCUPANCY FORM
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildinp(&cupertino.org
APNPROJECT
:316-07-049
BB2017-0519
DATE : 6/26/18
VALUATION $
SITE 1 Apple Park Wa
ADDRESS: pp Y
OWNER'S NAME: Campus Holdings, LLC
p 9
PHONE #: 408-996-6684
FAx #:
MAILING ADDRESS (if different from site address): 1 Infinite Loop, MS 21-AC2, Cupertino, CA 95014
CONTRACTOR/POINT OF CONTACT:
PHONE M
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
OUNT (1 % VALUATION
CODE
❑CHECK ❑CASH BOND
BOND: 5K min-10K max) $ [BLDBONDS]
FF
EDITION: 2010
TCO EXPIRATION
FEE: $329.00/mo
TOTAL FEE: $ [iTEMPOCC]
DATE (6 MONTHS MAX):
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
H21 A4 L2 P1
1 A
5,750 sf
64
L2
OTHER DEPARTMENT / AGENCY APPROVALS:
anninq
Signature: ......................................................... Date:....................
❑APPROVED
❑ APPROVED WITH CONDITIONS*
ire
Signature :. ............. .................... ....................... Date: .�.�..
-ITU-blioWorks
[]APPROVED
❑APPROVED WITHCONDITIQNS*
Signature: .........................................................Date:.......................
❑ APPROVED
D APPROVED WITH CONDITIONS*
Other:
Signature: ..... ...................................................Date:.......................
❑ APPROVED
El 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 inarrn orcem t action.
Owner 9 Contractor 6/26/18
Signature: ..: p .2.................... Date. 1&... 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 eme encie ,
Building Official:...A4A................................................Print:....................... �t.,�:!.il; :.L............Date:. (.......
DEPARTMENT ACTION: After determination. conies to: 11 annlicant. 21 nermit file
empOccFormg2013. doc revised 8122117
Wednesday, July 11, 2018 at 3:58:25 PM Pacific Daylight Time
Subject: (none)
Date: Tuesday, July 10, 2018 at 3:49:04 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 approval for A4,
L1 to Plant Level, with the following excluded areas:
Level 1 Pod 2 Product Lab Stands 003 and 004.
Level 1 Pod 10 Product Lab Stands 011 and 012.
Level 1 Pod 11 Bookend Lab H 15.
Level 2 Pod 10 Product Lab Stand 011 and X-Lab 012.
Level 2 Pod 11 Bookend Lab H09.
Regards,
Dirk
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