B-2019-0751 - CofOCofO Application.doc revised 06/01/20
COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING:
PROJECT ADDRESS CUPERTINO, CA APN # DATE
OWNER NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP
CONTRACTOR NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP
MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery):
CONTACT NAME PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP
LIST ALL BUILDING PERMITS ISSUED FOR PROJECT:
PERMIT NUMBER DATE FINALED INSPECTOR SCOPE
1
2
3
4
- OFFICE USE ONLY -
SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST:
Permit signed off in system? ________
No other permits open or expired in system? ________
Verification of payment for certification? ________
APPLICATION FOR CERTIFICATE OF OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • building@cupertino.org
10495 N DeAnza Blvd 2/24/21
Apple Computer Inc - Aaron Gates 415-405-6029 agates2@apple.com
1 Infinite Loop, MS 18-DDC Cupertino, CA 95014
Holder Construction Group LLC, Daniel Gorden 405-269-9343 dgorden@holder.com
2099 Gateway Place, Suite 340 San Jose, CA 95110
Holder Construction Group LLC, Daniel Gorden 405-269-9343 dgorden@holder.com
2099 Gateway Place, Suite 340 San Jose, CA 95110
B-2019-0751 2/22/2021 TI Office and Lab Retrofit, Building Final, Fire Alarm FinalBob Sabich,
Fardean Amadkani
CUPERTINO
10300 TORRE AVE
CUPERTINO, CA 95014
Receipt No.:272711
Receipt Date:02/26/2021
R E C E I P T
RECORD & PAYER INFORMATION
Record ID:
Record Type:
B-2019-0751
Magnet Converted
Property Address:10495 N DE ANZA Blvd, CUPERTINO, CA 95014-2028
Description of Work:APPLE DA 12 T.I. - (61069 SF); TI FOR 3-STORY OFFICE SPACE, CONFERENCE ROOMS,
LIGHT ELECTRONIC LABS, SERENITY ROOMS, MAIL ROOM, ALL GENDER RESTROOMS &
SHOWERS, BREAK-ROOMS AND COLLABORATION SPACES. (N) ROOF-TOP MECHANICAL
UNITS
REV # 1 - Minor layout changes – addition of storage room, white board walls, ERRCS room,
addition of dishwashers and updates to finish plans-ISSUED 12/05/2019
REV # 2 - MINOR LAYOUT CHANGES - CONVERSION OF CONFERENCE ROOM 101 INTO
SOUND ROOM. CONVERSION OF OFFICE 209 AND STORAGE 210 INTO LABS 209 AND
210. CONVERSION OF COLLABORATION 328 INTO OFFICE 328. RESULTING IN A
DECREASE IN OCCUPANT LOAD.TEEL SUBMITTAL 045 INCLUDED INSPECTOR'S
REQUEST FOR THE CANTILEVERED SOFFIT. PER -ISSUED 12-19-2019
REV#3 -NO NEW SITE WORK CONDUCTED
Payer:John Thomas
Applicant:N/A
Holder Construction Group LLC
3000
Riverwood Pkwy 1200
Atlanta, GA 30339
PAYMENT DETAIL
AmountCommentsCashierReferencePayment MethodDate
02/26/2021 Credit Card PUBLICUSER308
573
$419.00
FEE DETAIL
Fee Description Invoice #Quantity Fee Amount Current Paid
1.00 $419.00Occupancy - Certificate of Occupancy/Completion 54525 $419.00
$419.00$419.00
AA_Receipt_Template.rpt Print Date: 02/26/2021 Page 1