TCO - LAB SO7 A7 L3 P11TEMPORARY CERTIFICATE OF OCCUPANCY FORM
CUPERTINO
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building@cupertino.org
APN: 316-07-049
B B2%17-0519
DATE: 4/11 /18
PROJECT
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 #:
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/mo
TOTAL FEE: $ [1TEMPOCC)
DATE (6 MONTHS MAX):
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
Lab S07 A7 L3 P11
1 A
5,750 sf
59
L3
Previously excluded from A7 TCO
OTHER DEPARTMENT / AGENCY APPROVALS:
anrnnq
Signature: ........ ................................................
Date:.......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS'
Fire
Signature: .........
>-
Date: �.` Z �l D
[]APPROVED
❑ APPROVED WITHCONDITIONS-
u is Works
Signature: ................... .......... .........................
Date:.......................
O APPROVED
❑ APPROVED WITH CONDITIONS`
Other:
Signature: .........................................................Date:.......................
13APPROVED
El APPROVED WITHCONNTIONS`
*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 an enforcement action.
Owner `/. . 0 i/ Contractor
Signature: ...........:.............•...............,................. Date:..��1 &#...... Signature:................ ........................... Date:... 0¢ .
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 encie
Building Official ... ..."............................................................ Print: ............... Date:... Z-14—I
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
en:pOceForm[ 2013.doc revised 8/22117
Thursday, May 24, 2018 at 9:58:42 AM Pacific Daylight Time
Subject: Fwd: Status of 4LEAF Recommendation for TCO for A7 Level 3, Pod 11 Bookend S07, GL 91-92
Date: Thursday, May 24, 2018 at 9:55:13 AM 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 A7 Level 3,
Pod 11 Bookend S07, GL 91-92.
Regards,
Dirk
From: "Traci Caton" <tcaton@4leafinc.com>
To: "Albert Salvador" <AlbertS@cupertino.org>, "Dirk Mattern" <dirk.mattern@sccfd.org>
Cc: "Craig Tole" <ctole@41eafinc.com>, "Chris Fowler" <cfowler@41eafinc.com>, "Mike
Drake" <mdrake @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, May 23, 2018 12:56:31 PM
Subject: Status of 4LEAF Recommendation for TCO for A7 Level 3, Pod 11 Bookend S07,
GL 91-92
Good afternoon Albert & Dirk,
Pending SCCFD approval, 4LEAF is ready to recommend TCO for Bookend S07:
A7 Level 3, Pod 11.
Contractor is requesting an amendment to the existing A7 TCO to include Pod
11 on Level 3. This pod is identified in the plans as Bookend S07 and is part of
building permit no: B-2017-0519.
The Main Building area A7 L3 Pod 11, GL 91-92 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
• CSD approval of public tie-in prior to C of O. Flow has been verified for
TCO
• Final inspections for all excluded items from all Milestones and inspections
Pagel of 2