TCO-A5 L1 P11TEMPORARY CERTIFICATE OF OCCUPANCY FORM
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERTSALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
C U PERTI N O (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org
APN:
316-07-049 TB
B 2b17-0519
DATE: 5/22/18
PROJECT
VALUATION
SITE
ADDRESS: 1 Apple a le Park Way
y
OWNER'S NAME: Campus Holdings, LLC
PHONE M 408-996-6684
FAX M
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]
rF
EDITION: 2010
TCO EXPIRATION
FEE: $329.001mo
TOTAL FEE: $ [iTEMPOCCJ
DATE (6 MONTHS MAX):
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
Bookend Lab S06
1 A
2,750 sf
30
L1
A6 Li P11
OTHER DEPARTMENT 1 AGENCY APPROVALS:
anrnnq
Signature: .........................................................Date:................,......
❑ APPROVED
❑ APPROVED WITHCONDITIONS'
ire
Signature: ........... .....................................Date:
[]APPROVED
❑ APPROVED WITHCONDITIONS'
Public Works
Signature: ............... _ ...................... ................
ignature:........................................................ Date:.......................
❑ APPROVED
❑ APPROVED WITHCONDITIONS'
Uther.
Signature: .........................................................Date:.......................
❑ APPROVED
❑ APPROVED WITHCONDITIONS'
"CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of theproperty
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 m orary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-compliance
may result' an enforcemen ction.
Owner Contractor
Si nature:......... .......'............ Date; .. Z..1 Si nature :..................................................... Date: 5/22/1.8.....
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 emergencies4,
Building Official: ..... 1W . ......:... .... ..:......................Print:....... !.... . ...... ....(....................f..... ..... Date:
":�.�...Ll".U........
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
empOccForn&2013.doc revised &122117
Friday, September 28, 2018 at 11:09:41 AM Pacific Daylight Time
Subject: Fwd: Status of 4LEAF Recommendation for TCO for A6 Level 1, Pod 1, GL 68-69 S06 Bookend Lab
Date: Friday, September 28, 2018 at 10:53:23 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 A6 Level
1, Pod 1, GL 68-69 S06 Bookend Lab.
Regards,
Dirk
From: "Traci Caton" <tcaton@41eafinc.com>
To: "Albert Salvador" <AlbertS@cupertino.org>, "Dirk Mattern" <dirk.mattern@sccfd.org>
Cc: "Craig Tole" <ctole@4leafinc.com>, "Chris Fowler" <cfowler@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, July 25, 2018 3:40:16 PM
Subject: Status of 4LEAF Recommendation for TCO for A6 Level 1, Pod 1, GL 68-69 S06
Bookend Lab
Good afternoon Albert & Dirk,
Pending SCCFD approval, 4LEAF is ready to recommend TCO for A6 Level 1, Pod
1, GL 68-69 S06 Bookend Lab.
The Main Building Area A6 Level 1, Pod 1, GL 68-69 S06 Bookend Lab 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
• 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
inspections prior to C of O.
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