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10030059
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10555 MARY AVE CONTRACTOR:MT2 TELECOM,LLP PERMIT NO: 10030059 OWNER'S NAME: CITY OF CUPERTINO 3780 COMMERCE DR DATE ISSUED:03/10/2010 NER'S PHONE: 4087773354 W SACRAMENTO,CA 95691 PHONE NO:(916)376-8555 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# MECH r RESIDENTIAL r- COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:INSTALLATION OF FIBER MODEM BOX INTO AN (commencing with Section 7000)of Division 3 of the Business&Professions EXISTING Code and that my license is in full force and effect. CELL SITE LEASE AREA I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$4000 permit is issued. APPLICANT CERTIFICATION APN Number:32606052.00 Occupancy Type: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by:-� Date: 7-(d—Gd Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maint ' co ce with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's fety Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Ow er auth forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save inify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may,accrue against said City in consequence of the granting of this i.Addi'on the applicant understands and will comply ARCHITECT'S DECLARATION with all no o t e r ul io er the Cupertino Municipal Code,Section 9.18. / I understand my plans shall be used as public records. Signatur Date ) l 0 Licensed Professional CITY OF CUPERTINO 6 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32606052 . 00 DATE ISSUED. . . . . . . : 03/10/2010 RECEIPT # . . . . . . . . . : BS000009910 REFERENCE ID # . . . : 10030059 SITE ADDRESS . . . . . : 10555 MARY AVE SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CITY OF CUPERTINO ADDRESS . . . . . . . . . . : 10981 FRANCO CT CITY/STATE/ZIP . . . : CUPERTINO, 95014-1502 RECEIVED FROM . . . . : CHAD D CHRISTIE CONTRACTOR . . . . . . . : JON MORENO LIC # 31419 COMPANY . . . . . . . . . . : MT2 TELECOM, LLP ADDRESS . . . . . . . . . . : 3780 COMMERCE DR CITY/STATE/ZIP . . . : W SACRAMENTO, CA 95691 TELEPHONE . . . . . . . . : (916) 376-8555 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 4, 000 . 00 1. 00 0 . 00 1 . 00 0. 00 1BSEISMICO VALUATION 4, 000 . 00 0 . 84 0 . 00 0 . 84 0. 00 1EPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0. 00 1MECHINSP HOUR 1 . 00 126 . 00 0 . 00 126 . 00 0. 00 1MPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 253 . 84 0 . 00 253 . 84 0 . 00 CITY OF CUP ERTINO CUPEI�TINO GENERAL BUILDING PERMIT APPLICATION FORM APN # 2� � ��a V Date: / 0 Building Address: 105S5 MAle-q AV 0 Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes ❑ No HOA: (Exterior work only) Yes ❑ No P�lf yes, provide letter from HOA Ow�Ilr� r'sName: - 9 Phone#: ..., G ,CPE 1:T V+G Contractor: Q Phone: • N—F C Fax: Contractor License#: 7,Z7 0 of Cupertino Business License#: Contact: Phone: c7 (6-3?k-1 Y v C64C Q17-7 Fax: Residential ❑ Commercial ff Job Description: (n1X}LL.4Tl r� 7-0 Ao-.% t s�'�..� �Lam_ 5 r 7-A - ISS Ao-eA Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ IUIII/V-A ❑ IUIII B, IV-HT, V-B ❑ Valuation: dam_ Square Footage: ®On Project Size: Express ❑ Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it to the application or if applicable, include in plan set& the sheet index. Points Achieved: For help, contact Build it Green at www.buflditgreen.org Revised 07/14/09 CITY OF CUPERTINO Cin OF GENERAL BUILDING APPLICATION CUPEf�TtNO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee' Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1WINMEWSTR New Window-structural shear B wall/masonry(includes plan ck fee) I EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck(hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1TRAVDOC Travel &Documentation B 1BUSLIC Business License B GLS �'G�► �J' 5 of 5 SITE ID: SF04551a WORK ORDER#: 731019 M 2 SITE NAME: SF551 t VBID TEL E001w, L1`r ADDRESS: 10555 Mary Avenue 1 0 3780 Commerce Drive CITY: Cupertino BY: West Sacramento, CA 95691 STATE: CA 916-376-8585 1 t ,�,>vF rZIP CODE 95014 T,, F c,+�,©i License #9271 WALKED BY: MT2 TELECOM,L.P. C L„ � DATF (w� T MOBILE PM: TERRY BUCK 916-420-3531 _ SfGNE AT&T CONTACT: AARON SHEPARD 408-493-7194 t�f��r '¢ r This set of plans ands , d ? s be kept on the lob a .�,ati�n,, NOTES: unia n fut to make any + T_Mobile/MT2.Telecom will provide a clear path for the new fiber optic cable from the E on same without war t ,t C;,i rtu�o. P P Pt ( ) �artr, wireless facility to the ATT MPOE as determined from field visit. the 43uildin9 De�' � h� stamping o tht«x t, �n, The- ,c” �t n' ' ATT will route a new fiber optic cable to the new DMARC located in the T-Mobile lease area as SHALI NC)T br hr•I f 1 shown in attached photos and site sketch. i •,; , app,o,al of the w<ri it * Of any t,it y >rdKyJr�te ' T-Mobile/MT2 Telecom will coordinate and manage the construction of the fiber path, equipment installation and all other necessary conduit routing within the lease area. k„ Mx ATT will terminate the fiber optic cable at the FTP and their ' �. �s; 4 All bends to conduits need to be at least 18 unless specified SOW: �m • Meet Point—Existing AT&T facilities outside of lease area. InstaT57W-c " tape in 2" conduit that runs from phone room to existing Telco box at site. • Install(N)22"x20"x10"Telco Box. • FDP to UAM: 10'of 1 W conduit with'/z"mule tape. H-Frame-CIENA:New H-frame for Ciena and(N)Telco Box(20'of P1000 Unistrut& connectors). • CAT5:(4)runs of 15'each(100'total)in 15'of new 1 V conduit. • Power:(1)tun of Red&Black#10 of 20'each in 15'of new'/"conduit. • Ground:(1)run of 2546 Ground in 20'of new%"conduit to MGB adjacent to cabinet. • Note: GC will make all necessary digital labeling to newly installed lines and conduits. 'N) 22' X 20- X !0, -Dry TFLCO BOX ON NEW PlC00 :.;%� !S7RUJ PL[)ISTAL 114- CONDUIT ;-ROM (%.,) IL-CO L30X TO ';AM W/ 1.12 YUP 7 TAPF F—PROPCSIED 22" X 20" X 10- TELCO BOX, %CIEINA BOX 'AT&T INSTAL ) do LAM BOX PER "ONTRACTrr (AT&T IN ON LLFI & T-MOBILE OUT ON RIGHT) 0N NE PFLITSTk. _w P4,0010 UNISIRU,i R&F3 iN 1/7" I_t/4' CONIDVTru'RN;D iN. 1/2' kC0NCU1,7 FROM (F) TFL(M CAN TO (N) 22* X 20' X (F) VIGB 10- TELCO BOX W/ 112" MULE TAPE (E) GENFRATOR (E) PBms (F:) TELCO ,3T s FROM (L) ILCO NO CAN PROVIDE 2" � FOIE CONDUIT W1 112" MULE TAPE TO MEET POINT ±550' FROM SITE __.__. (2) CAI-5 CABES =JER CAH/HTS ;v 1-*/4" CONDO SCALE 3/8' • T-0* ST AM DRAM 91. SF0455'A aAa vt:>o -T, , ,mobiles 5F551 HWY '85 10555 MARY A Ir 190 CuPl'tHIINO. CA 9 14 &AwAmv4TA CA. VAM SITE LAY UT VAR TINE1, R fi� V10 COMVFRCF OR Y noxkAmr?m rA ossor (SPIE) a".5 A-0 IST' WCW L LR CN JNRACKET CN 3911 MOUNTING BACKERCABINET � MOUNTING FASTENEDD TO TO SUPPERS BRACKETS w/Y.-1D SCREWS \ HORIZONTAL SUPPORT BRACKET CABINETS FASTENED TO SUPPORT BRACKETS W/Y-20 SCREWS TM --3'-0'(e'MAX) DETAILS NFRPCAI SUPPORT BRACKET ENO CAP felt VERTICAL SUPPORT BRACKET � �PIPE 7W GALV UNISTRUT P10O1 TV\ GALV IINISTRU7 P1001 TM / STEEL UNISTRUT STRAP P/N Pn20 OR ISSUE STATUS s EQUIV AS OCCURS NF I I I I I DALE I DESCRIPTION I By I I L J I I I iZ-03-09 E%HIBIT II II II II 1 II II I i GALV UNISTRUi O I'll,Di TW HORIZONTAL UNIS7RUT SHOULD DRAWN BY: K.SANSE L BE BETWEEN 1J'&13'APART I I I I I CHECKED BY. 1.HOUGHTBY (18'IS PREFERRED) 6 APPROVED BY:MAX II II I I I 11 I OAIE'. 12/07/09 II II I II o o II I ee --- _-- 03Y-GALV PIPE POST TV iYP :¢i?.t UAM CABINET MOUNTED TO SUPPORT 6'-0- MAX BRACKETS W/X-20 SCREWS I ` rvisy I II I 6�tn l.b tli[T UAM W/MOUNTING BRACKET TV I Q; V 16 J!1 GRADE OR SCAR �:,�1. �°'LL1/ I I I I I I I I I IE X- PIPE POST FOOTING ~~ 2'-0'MIN 42" E its; 1 1 J UNISTRUT P2072SO Gin POST BASE OR EQUIV I aH FRONT VIEW SIDE VIEW FRONT VIEW SIDE VIEW CN3911 & UAM H-FRAME MOUNTING DETAIL FUTILITY H-FRAME DETAIL UNISSRUT PIDOO TOP&BOTTOM MINVERTICAL MOUNTING BRACKET LENGTH AS REQUIRED PROVIDED BY CABINET MANUFACTURER7-7 Or BOLT,SPRING NUS,&WASHER�`� 1 (16 1') I I I I I (—(16.2') EQUIPMENT CABINET 1 PER PIAN UNIS7RUT PI000 H-FRAME TOP VIEW POST LENGTH AS REQUIRED TOP VIEW 6, I I O (172•) SHEET TfiLE: I I FRONT VIEW SIDE VIEW FRONT VIEW SIDE VIEW H-FRAME MOUNTING DETAILS CN 3911 DETAIL UAM DETAIL H-FRAME CABINET MOUNTING DETAIL SHEET NUMBER: Community Development a�al 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 :UPEkTINO Buildin De artment JOB ADDRESS: PERMIT # OWNER'S NAME: ''. , PHONE # q1 GENERAL CONTRACTOR: Tj TZ .T LCFAX # I am not using any subcontractors: Signature Da e Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date