TEMPORARY CERTIFICATE OF OCCUPANCY FORM (COMMUNITY DEVELOPMENT DEPARTMENT + BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.0., BUILDING OFFICIAL 410300 TORRE AVENUE « CUPERTINO, CA 95014-3255 (408) 777-3228 + FAX (408) 777-3933 - bulldina@cupertino.org | CUPERTINO | *N316-06-061 |" 14020124 CATE geya017 | YacuaTion: § SE ‘STE egg. 10501 North Tantau Avenue, Cupertino, CA 95014 PHONE # ONNERS KAYE" CAMPUS HOLDINGS, LLC | Fax: MAILING ADDRESS (f diferent rom site adéres5):+ Infinite Loop, MS 21-1 AC2 Cupertino, CA 95014 CONTRACTOR: Tr yebeck Construction Pee [SON Eric Simpson PHONE oo; padwand Shores Pata, Site 125, Raton Cy CA 085 TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION BOND TYPE: LISURETY BOND | awounT (196 VALUATION CODE Deneck _Choasnsono | or'wonb: Simian mon) $ (e080%08) | eovrion: 2010 TO EXPIRATION coe uos ae FEE: $296,00/mo | TOTAL FEE: $ (vTemPocc) Use TWPEOF | FLOOR | Ge | LEVEL | COMMENT Gonsre_| ‘AREA | LOAD A1 and S2 Occupancy \-B 122,388 SF} 1730 | B1-B4 Auditorium and Loading Ramp Ag Occupancy | li-B _ |36,904SF| 2511 | Ba Hands On and Lobby OTHER DEPARTMENT / AGENCY APPROVALS: [Eee ~ pam D/H APROveD 0 APPROVED WITH CONDITIONS ean pate ASA; Darproven —_y-KBPROVED WITH CONDITIONS" pl 7 ate. 2/717, BKapproveo 0 APPROVED WITH CONDITIONS: Signature 2 ae Clapproveo 1 APPROVED WITH CONDITIONS “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 ofthe above request for temporary occupancy to have the buiding or buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior tothe expiration ate specified. I this Temporary Certificate of Occupancy expires, the total amount ofthe bond may be forfeited and the non-compliance Se a owe. eg Seated on [ext]. “This temporary cerlifcate ensures that all fre protection and ife safely systems have been completed, Inspected, successfully tested and approved for the specific area ofthe building specified above to provide a reasonable degree of safety to the occupants trom fre and similar emergencies, ia Buiing nat. JIL SOLOS pene RAC SALVADOR ones CETL DEPARTMENT ACTION: Afier determination, copies (0: 1) applicant, 2) permit fle TempOceForm_2013 doc revised 6/30/16TEMPORARY CERTIFICATE OF OCCUPANCY FORM ‘COMMUNITY DEVELOPMENT DEPARTMENT + BUILDING DIVISION ALBERT SALVADOR, PE, CB.©,, BUILDING OFFICIAL 110800 TORRE AVENUE + CUPERTINO, CA 95014-3255 CUPERTINO | 408)777-3208 + FAX 408) 777-3833 buldnag@caperto ora “Pv 316-07-049 _|°* 14020127 ATE'7/19/2017| Vacuavion. $ SE aopress. _1 Apple Park Way OANERSTANE” CAMPUS HOLDINGS, LLC [Pac MAILING ADDRESS (f different trom site address): 1 Infinite Loc }op, MS 21-1AC2 Cupertino, CA 95014 CONTRACTOR: older Construction Company PRONE # 408-787-1826 CORTE oa Tuer PEC Ts ony Pass Se Sen oe a0) | TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION BOND TYPE: [SURETY BONO | qwount 796 VALUATION ODE | ocueck _Geasneono | Sr'Bonb: Semon may $ {.080N05) | enrmion: 2010 TCO EXPIRATION : : eee ON ao FEE: §296,00/mo | TOTALEEE: iTeMPoco) USE Tyeeor | FLoon ] oce | Level | comment — conse _| ‘Anca | Coab Restaurant At 1A [526,928 sqm] 972 | B2, B1, | Ooee notice L1 Avum, and Root Pant spaces Ocoupancies: L1, L2, [Retertoeterencemape for prc eope and eta B, FA, F-2, $1, $2 13,14 orwen ENCY APPROVALS: (ee Ces pec gag ais emnorm Tema wnianenme = wo LL Srna Date: L612 _K{APPROVED _(] APPROVED WITH CONDITIONS Te 7a) Me — oon 25127 _Oremoneo Carman ymigperaye nea jc TD apenaven 0) APPROVED Wit CONDITIONS “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. pte tn a ing codes, oranoes ad epors ad ray wapcin ple expan Certificate of Occupancy expires, the total amount oft be forfeted and the non-compliance date: 3120/19... Signature ry cerifcale ensures thal all fire protecion and le safety systome have been completed, nepecied, successfully tested and ‘area ofthe building spectiod above to provide a reasonable degree of safely io the occupants fom fre and ‘DEPARTMENT AGTION: Alor determination, copies 1) applicant, 2) permite ‘TempOceForm_2013 doc revised 6/30/16