TCO-BOOKEND LAB H07 A6 L4 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-building@cupeOino.org
APN:PROJECT
316-07-049
TB$-2()17-0519
DATE: 5/22/18
VALUATION
SITE
ADD 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: ❑SURETYBOND MOUNT (1%a VALUATION CODE
❑CHECK F BOND: 5K min-10K max) $ 2010
❑CASH BOND [BLDBQNDS] EDITION:
TCO EXPIRATION FEE: S329.00/mo TOTAL FEE: $ [1T'EMPOCC]
DATE (6 MONTHS MAX):
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
Bookend Lab H07
1 A
5,750 sf
57
L4
A6 L4 P1
OTHER DEPARTMENT / AGENCY APPROVALS:
Filanninq
Signature: ......................................................... Date: ..... ............pp.....
❑ APPROVED
❑ APPROVED WITHCONDITIONS'
Siire 0`1" t 4 '
gnature: .........................................................Date:.......,...........,._
❑ APPROVED
❑ APPROVED WITHCONDITIONS'
Public Works
Signature: ... ................ Date:.......................
❑ APPROVED
❑ APPROVED WITHCONDITIONS'
Uther:
Signature: .................. .... Date:..........,.. ....
❑ APPROVED
❑ APPROVED WITHCONDITIONS-
'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 infan• srfto""rceme clion.
Owner Contractor
118
Si nature:..........,..-.-- ..... ~............. Date:.-� ZJr..I ;.. Signature:...... ............................................... Date: 5/22...---
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 emergencies,
f �
C �1
BuildingOfficial• .. _k, Print:..... '� `� v........6....j`:..........Date:..E?.... At? ........
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
emp0ccForn f 2013.dac revived V2 217 7
Thursday, June 7, 2018 at 4:23:43 PM Pacific Daylight Time
Subject: Fwd: Status of 4LEAF Recommendation for TCO for A6 Level 4, Pod 1 Bookend H07, GL 68-69
Date: Thursday, June 7, 2018 at 3:17:02 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 Bookend
H07: A6 Level 4, Pod 1.
Regards,
Dirk
From: "Traci Caton" <tcaton@41eafinc.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: Thursday, June 7, 2018 2:53:01 PM
Subject: Status of 4LEAF Recommendation for TCO for A6 Level 4, Pod 1 Bookend H07, GL
68-69
Good afternoon Albert & Dirk,
Pending SCCFD approval, 4LEAF is ready to recommend TCO for Bookend H07: A6
Level 4, Pod 1.
Contractor is requesting an amendment to the existing A6 TCOs to include Pod 1
on Level 4. This pod is identified in the plans as Bookend H07 and is part of
building permit no: B-2017-0519.
The Main Building area A6 L4 Pod 1, GL 68-69 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
prior to C of O.
Pagel of 2