TCO - SECTOR A5 L3TEMPORARY CERTIFICATE OF OCCUPANCY FORM
CUPERTINO
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERTSALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - buildingCWcupertino.org
APN: 316-07-049
BP3#20072, 1a020126, 14020131
DATE: 8/9/1
JECT
VAOUATION
SITE 1 Apple Park Wa
ADDRESS: pp y
OWNER'S NAME: Campus Holdings, LLC
p
PHONE #: 408-996-6684
FAX 4
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: (QSURETY BOND AMOUNT (1% VALUATION ODE
[]CHECK [I CASH BOND F BOND: 5K min- 10K max) $ (BLDBONDS][EDITION: 2010
TCO EXPIRATION FEE: S329.00/mo TOTAL FEE: $ f 1TEMPOCC]
DATE (6 MONTHS MAX):
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
Sector A5 L3
1 A
57,016 sf
772
L3
Pods 3-10
OTHER DEPARTMENT 1 AGENCY APPROVALS:
annq
Signatature:.........................................................Date:...............,.......
CIAPPROVED
E3 APPROVED WITHCONDITIONS-
ire
Signature .
....................
�
Date:. � .172
[]APPROVED
p APPROVED WITMCONDITIONS"
Public Works
Signature: . . . ...................................................
Date: ...................
APPROVED
0 APPROVED WITH CONDITIONS`
Other:
Signature: .........................................................
Date:.......................
D 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 in an enforcement action.
Owner / `� Contractor ZI
Signature: .. :l......................... Date:. 817f/ F... Signature:....... Date: 8/9/18........
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 encies
BuildingOfficial: ..... :..................X .....a.....'....... ............ Print: ...... ....! 11. <. ... .......1.1.r.:................. Date: ... .... k:7:.1A..
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
etnp0ccFom&7013.doc revised 8/22/17
Thursday, August 16, 2018 at 2:53:46 PM Pacific Daylight Time
Subject: Fwd: Status of 4LEAF Recommendation for TCO for A5 Level 3, Pods 3 through 10, Gridlines D-L/57-
65
Date: Thursday, August 16, 2018 at 11:46:18 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 TCO approval for A5 Level 3,
Pods 3 through 10, Gridlines D-L/57-65..
Regards,
Dirk
From: "Traci Caton" <tcaton@41eafinc.com>
To: "Dirk Mattern" <dirk. matte rn@sccfd.org>, "Albert Salvador" <AlbertS@cupertino.org>
Cc: "Chris Fowler" <cfowler@4leafinc.com>, "Craig Tole" <ctole@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: Saturday, August 11, 2018 12:55:58 PM
Subject: Status of 4LEAF Recommendation for TCO for A5 Level 3, Pods 3 through 10,
Gridlines D-L/57-65
Good afternoon Albert & Dirk,
Pending SCCFD approval, 4LEAF is ready to recommend TCO for A5 Level 3, Pods
3 through 10, Gridlines D-L/57-65.
The Main Building A5 Level 3, Pods 3 through 10, Gridlines D-L/57-65 are
substantially in conformance with approved construction documents & Project
Designers revisions. Please 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.
• Maintain construction area separation of Pods 1 & 2 per CBC-CH.33
• Obtain City of Cupertino Approval of the E4 TCO.
• 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.
Pagel of 2