10030058CITY OF CUPERTINO BUILDING PERMIT
I BUILDING ADDRESS: 10420 BUBB RD
I OWNER'S NAME: THE HOME OF CHRIST CHURCH
NER'S PHONE: 4085222700
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #
Contractor
Date
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
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
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature
Date
OWNER -BUILDER DECLARATION
f hereby affirm that I am exempt from the Contractor's License Law for one of
:he following two reasons:
�, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
[, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
CONTRACTOR: MT2 TELECOM, LLP I PERMIT NO: 10030058
3780 COMMERCE DR , DATE ISSUED: 03/10/2010
W SACRAMENTO, CA 95691 ( PHONE NO: (916) 376-8555
BUILDING PERMIT INFO: BLDG ELECT r PLUMB
MECH r RESIDENTIAL F COMMERCIAL
I hereby affirm under penalty of perjury one of the following three
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
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
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
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
JOB DESCRIPTION: INSTALLATION OF FIBER MODEM BOX INTO AN
EXISTING
CELL SITE LEASE AREA
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
i- ' �mnify and keep harmless the City of Cupertino against liabilities, judgments,
and expenses which-Awhichyd—A accrue against said City in consequence of the
g ing a ddit' y, the applicant understands and will comply
wuh al
on
int u ere l o s per the Cu ertino Municipal Code, Section
9.18. 1 r
Date 16/1C>
Sq. Ft Floor Area: I Valuation: $4000
APN Number: 35720038.00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Date:
Issued by:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(x) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maint. ' r co�i�the Cupertino Municipal Code, Chapter 9.12 and the
etv a tions 25505, 25533, and 25534.
t: ate: i 0
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
6 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 35720038.00
DATE ISSUED.......: 03/10/2010
RECEIPT #......... BS000009910
REFERENCE ID # 10030058
SITE ADDRESS 10420 BUBB RD
SUBDIVISION ......
CITY CUPERTINO
IMPACT AREA ......
OWNER THE HOME OF CHRIST CHURCH
ADDRESS 10420 BUBB RD
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
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
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
1TRAVDOC
FLAT RATE
1.00
42.00
0.00
----------
-----42_00
------0_00
TOTAL PERMIT
----------
253.84
0.00
253.84
0.00
SIM
CITY OF
CUPERTINO
CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
rffldl/•
APN #
'7 10 U�3� CAS
Date:
Building Address:
0L00
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 ❑ If yes, provide letter from HOA
Owner's Name:
Phone #:
8- 5 Z7O0'
E ove-' G+4e-►s'r'" CNL.Xc OJ
Contractor: Ctk 542-4-10
Phone:
jYli'
Fax:
Contractor License #: 2QV0
Cupertino Business License #: A
Contact:
Phone:
CAArka
Fax:
Residential Commercial
Job Description: �-3 '5 v of" z -t . cE.D b F /A F i 6 C iL- #m 0DF •tit � �k
Cil 1 ► !� 1.-f_�i �E_ lane.
Building Permit Info:
Bldg S� Elect E� Plumb ❑ Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ IUIII B, IV -HT, V -B
-
Valuation:— Square Footage:
OcO
Project Size: Expressffr ExpressStandard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Uhecktist & attach it
to the application or if applicable, include in plan set & the sheet index.
Points Achieved:
For help. contact Build it Green at
Revised 07/14/09
CITY OF CUPERTINO
Urn of GENERAL BUILDING APPLICATION
CUPEkT1NO FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
1 MECPLNCK
1STUCOAP
Stucco Applications (up to 400 sf)
additional stucco application
B
Stand Alone Plumbing Pln Ck (hrly)
P
1 WINREP
Replacement windows/sliding glass
door (ea 8 windows)
B
1 WINMEWSTR
New Window -structural shear
wall/masonry (includes plan ck fee)
B
B
l EPERMITFEE
Electrical Permit Fee
E
1 MPERMITFEE
Mechanical Permit Fee
M
I
1PPERMITFEE
Plumbing Permit Fee
P
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic Residential B
/ 1BSEISMICO Seismic Commercial B
1 TRAVDOC Travel & Documentation B
1BUSLIC Business License B
5 of 5
IELCPLNCK
Stand Alone Electric Pln Ck (hourly)
E
1 MECPLNCK
Stand Alone Mechanical Pln Ck (hrly)
M
1 PLMBLNCK
Stand Alone Plumbing Pln Ck (hrly)
P
1 STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no E/M/P)
hourly -stand alone
B
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic Residential B
/ 1BSEISMICO Seismic Commercial B
1 TRAVDOC Travel & Documentation B
1BUSLIC Business License B
5 of 5
SITE ID:
SITE NAME:
MTADDRESS:
CIN/STATE:
3780 Commerce Drive
WALKED BY:
West Sacramento, CA 95691, vF �
IN a; ()H( '1 �aE "Ty of
916-376-8585cui'i w ' I .t' , OHDINANCEs T MOBILE PM:
License #927009 DATE U�� G AT&T CONTACT:
s MUST
nd it is
alteratio6s
Sion from
�ations
tie an
SF04569A WO#731135
SF569 (JOLLYMAN PARK)
10420 BUBB ROAD
CUPERTINO, CA 85014
MT2 TELECOM, L.P.
TERRY BUCK 916-420-3497
KEITH WALTERS 408-348-1542
NOTES:
T -Mobile / MT2. Telecom will provide a clear path for the new fiber optic cable from
the (E) wireless facility to the ATT MPOE as determined from field visit.
ATT will route a new fiber optic cable to the new DMARC located in the T-Mobil6
lease area as shown in attached photos and site sketch. j�
T -Mobile / MT2 Telecom will coordinate and manage the construction o�
path, equipment installation and all other necessary conduit routing rithin the Iii ]1
area.�j� 2010 �J
ATT will terminate the fiber optic cable at the FTP and theirlmP[�
All bends to conduits need to be at least 18" unless specified
SOW:
Meet Point — Existing AT&T facilities outside of lease area. Install 580' of mule
tape in existing conduit that comes from AT&T existing facilities to existing Telco
box.
FDP to LIAM: 15' of 1 %" conduit with 1/2" mule tape.
H -Frame - CIENA: New H -frame for Ciena (20' of P1000 Unistrut & connectors)
grafted to existing frame legs with the addition of a slab mounted post.
New 18" x 18" box for FDP.
CATS: (4) runs of 15' each (90' total) in 20' of new 1 %" conduit.
Power: (1) run of Black and White #10 of 15' each in 10' of new %" conduit.
Ground: (1) run of 30'#6 Ground in 25' of new 1/2" conduit to MGB adjacent to
cabinet.
Note: GC will make all necessary digital labeling to newly installed lines and
conduits.
PROPOSED 18" X 18" BOX, CIENA BOX
W Z (AT&T INSTALL) & UAM BOX PER
CONTRACT (AT&T IN ON LEFT &
T—MOBILE OUT ON RIGHT) ON NEW
z P1000 UNISTRUT PEDESTAL
m
U
W
11 F
U
J
W I
w
NEW 4" CONDUIT THROUGH PARKING
LOT TO 30" X 60" SPLICE BOX NEAR
STREET FROM (E) TELCO CAN PROVIDE
1/2- MULE TAPE TO MEET POINT
±560' FROM SITE N
` 1-1/4" CONDUIT FROM TELCO CAN
TO UAM W/ 1/2- MULE TAPE
(2) CAT -5 CABLES PER
CAB/BTS IN 1-1/4' CONDUIT
c
a (2) #10 B&W IN 1/2" CONDUIT
C
c
X
C
Z
I
G
G
(1) #6
GRND IN I
1/2"
CONDUIT
J
_
,J
�
G
Q
C
(E)
MGB I
G
C
C
I
1
G
C
(S
u
c
v
SCALE: 1/2' = 1'-0'
SITE INFO:
1
DRAWN BY:
JACEVEDO
T �1Vl�bile
J
9A
P RK
SF0ABN
{
SF564 JOA
1755 CRmcS1DE OAKS DRIVE
10420
CUP RTINA 014
DATE:
TD6�
SurrE iso
SACRAMENTO, Ca 95833
PF)0
0
R \v
AX:.(916)643 891
8 �
G
REVIEWED BY:
`
SIE L UT
SAL MARTINEZ JR.
3780 COMMERCE DR
W SACRAMENTO, CA 95691
`
REVISION:
2 (916) 376-8585
A-0
MIT TELECOM, L.P.
CH 3911 CABINET
CN 3911 NDUNTWC BRACKETS
FASTENED TO SUPPORT
BRACKETS W/ Y -20 SCREWS
MORI ZON1AL SUPPORT BRACKET
KRTICAL SUPPORT BRACKET
GALV UMSTRUT PIOO1 TYP
HORIZONTAL UNISTRU
BE BETWEEN 13' 9 i
(18' IS PREFER
L
UAW CABINET MOUNTED TO SUPPOR
BRACKETS W/ Y-20 SCREW
UAM W/ MOUNTING BRACKET TY
UNISTRUT P2072S
POST BASE OR EOUI
FRONT VIEW SIDE VIEW
CN3911 & UAM H -FRAME MOUNTING DETAIL
F (161') -I
TOP VIEW (64)
17.10
G
FRONT VIEW SIDE VIEW
CN 3911 DETAIL
3 --
'ETS W/ Y-ZO SCi
:AL SUPPORT BRA(
UNISTRUT P10D1 1'
(16.2')
TOP VIEW
(64-)
FRONT VIEW
SIDE VIEW
�YL\}'LIAM
'*=1
DETAIL
FRONT VIEW
STEEL UNISTR
>TRAP P/N P1120
.OUIV AS OCCURS
TO
IF
FOOTING
UTILITY H -FRAME DETAIL
P Y.-1,
UNISTRUT PID00 TOP A BOTTOM MIN
LENGTH AS REQUIRED
UNISTRUT P1000 H -FRAME
POST LENGTH AS REOUIREO
SIDE VIEW
VERTICAL
PRONGED
MANUFACTURE
Or BOLT, SPRING NUT, A WASHER
r,
EQUIP
PER e
H -FRAME CABINET MOUNTING DETAIL
-3.
CABINET
MOUNTING
DETAILS
ISSUE STATUS
DATE DESCRIPTION BY
17-03-09 EXHIBIT
DRAWN BY. K. SANSO
OIEOA(ED BY. 1. H""'Y
APP.1ED BY: -
DATE: 12/03/09
" $
0 9 _ 3
IT
.40a
3'E ^.1i
Oi i &ys � 2Ws{
ti
a ' w Saye
e. A
e ¢�R
SHEET TITLE:
H -FRAME
MOUNTING DETAILS
SHEET NEWER:
1 OF 2