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10030063CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20401 STEVENS CREEK BLVD CONTRACTOR: MT2 TELECOM, LLP PERMIT NO: 10030063 OWNER'S NAME: WDV PROPERTIES 3780 COMMERCE DR DATE ISSUED: 03/10/2010 1ER'S PHONE: 9252886689 W SACRAMENTO, CA 95691 PHONE NO: (916) 376-8555 ❑ LICENSED CONTRACTOR'S DECLARATION[_ r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. # MECH F_ RESIDENTIAL r- COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALLATION OF A FIBER MODEM BOX INTO AN (commencing with Section 7000) of Division 3 of the Business & Professions EXISTING CELL SITE LEASE AREA 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 Sq. Ft Floor Area: Valuation: $4000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31626094.01 Occupancy Type: 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 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. Date:-T � Issued by:v Signature Date lv/ 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: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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 & Safety Code, Section 25532(a) should I store or handle hazardous material. Section 3700 of the Labor Code, for the performance of the work for which this 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 n com is a ith 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 & ety , Sections 25505, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, I 7ealt become subject to the Worker's Compensation provisions of the Labor Code, I must th ri agent: Date: � U// O forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 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 mnify 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 o is it io ly, the applicant understands and will comply ARCHITECT'S DECLARATION with al on- in rce r i ns per the Cupertino Municipal Code, Section 9.18. I understand my plans shall be used as public records. / Sign ure Date �� Licensed Professional 6 ITEMS OF 36 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31626094.01 DATE ISSUED.......: 03/10/2010 RECEIPT #......... BS000009910 REFERENCE ID # ...: 10030063 OPERATOR: patg COPY # : 1 SITE ADDRESS 20401 STEVENS CREEK BLVD SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER WDV PROPERTIES ADDRESS ..........: 920 W FREMONT AVE CITY/STATE/ZIP ...: SUNNYVALE, CA 94087-3020 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 METHOD OF PAYMENT AMOUNT REFERENCE -------------------- NUMBER ----------------- --------------- CHECK 1,522.83 #323 --------------- TOTAL RECEIPT 1,522.83 CITY OF CUPERTINO CITYCUPEI�TINO GENERAL BUILDING PERMIT APPLICATION FORM APN # 1 (-J--� Lcq. V1 Date: 3 �a Building Address: 20 ATE 0 E,'V S 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' Name: : Phon #: D Piz - Contractor: Phone: M 2— T M r Fax: Contractor License #: V2,706q Cupertino Business License #: Contact: 0t4 A.8 G42, sa-t ]E-- Phone: Fax: Residential ❑ Commercial Job Description: Building Permit Info: Bldg KL-- Elect Lam---- - Plumb ['— Mech Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ IUIII/V-A ❑ IUIII B, IV -HT, V -B Valuation: ®� Square Footage: 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.b .o Revised 07/14/09 ha� CITY OF CUPERTINO CITY OF CUPERTINO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1GENCOM 1 STUCOAP Stucco Applications (up to 400 sf) additional stucco application B 1 WINREP Replacement windows/sliding glass door (ea 8 windows) B 1 WINMEWSTR New Window -structural shear wall/masonry (includes plan ck fee) B I EPERMITFEE Electrical Permit Fee E I MPERMITFEE Mechanical Permit Fee M IPPERMITFEE Plumbing Permit Fee P I ELCPLNCK Stand Alone Electric Pln Ck (hourly) E I MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M IPLMBLNCK 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 IBCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES IBSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B ITRAVDOC Travel & Documentation B IBUSLIC Business License B `("I g l,�j 5 of 5 M T 3780 Commerce Drive West Sacramento, CA 95691 916-376-8585 N PE 0 � ORDI OF AN ES License ODES AND C n _)D beh0P"' — �,w1ul to mus T tttnes nd Aerations SITE ID: SF04552a WORK ORDER #: 731020 SITE NAME: SF552 ADDRESS: 20401 Stevens Creek Blvd CITY: Cupertino STATE: CA ZIP CODE 95014 BV WALKED BY: MT2 TELECOM, L.P. I.� T MOBILE PM: TERRY BUCK 916-420-3566 AT&T CONTACT: NESTER PEREZ 408-310-8566 • 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 -Mobile lease area as shown in attached photos and site sketch. • 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. • ATT will terminate the fiber optic cable at the FTP and their MPOE • All bends to conduits need to be at least 18" unless specified • SOW: • Meet Point — AT&T will meet at (E) 3'x5' Splice Box located on concrete pad 10' east. • Install 20' of 1 W conduit from (E) Telco Box to (N) UAM. • Install 370' of %" Mule Tape from Meet Point through MPOE to (E) Telco Box continuing to (N) UAM. • H -Frame - UAM: New Wall Mount for UAM (30' of P1000 Unistrut & connectors). • CAT5: (2) runs of 20' each, (2) runs of 40' each (120' total) in 20' of new 1 '/<" conduit. • Power: (1) run 20' each of Red and Black #14 in 15' of new 1/2" conduit. • Ground: (1) run of 2546 Ground in 15' of new 1/2" conduit to MGB adjacent to cabinet. • Note: GC will make all necessary digital labeling to newly installed lines and conduits. ■ SITE INFO: FROM (E) TELCO BOX PROVIDE 1/2" I MULE TAPE IN (E) 2" CONDUIT TO MPOE ROOM, CONTINUING IN (E) 4" CONDUIT TO 3'x5' AT&T SPLICE BOX (MEET POINT) ±330'-0" FROM SITE 1-1/4" CONDUIT FROM (E) TELCO BOX TO (N) UAM W/ 1/2" MULE TAPE I (2) CAT -5 CABLES PER CAB/BTS IN (E) CONDUIT I I PROPOSED CIENA BOX (AT&T INSTALL), I UAM BOX PER CONTRACT (AT&T IN ON LEFT & T—MOBILE OUT ON WALL 1) #6 GROUND MOUNT P1000 UNISTRUT PEDESTAL--\ I IN 1/2" CONDUIT •e' (E) BTS (E) GAS METERS `� (E) BTS (1) RUN EACH OF RED AND BLACK #14 IN 1/2" CONDUIT '�_`y% (E) POWER (E) TELCO BOX 1-1/4" CONDUIT FROM (N) UAM TO (E) TELCO BOX FOR CAT -5 DISTRIBUTION SCALE: 1/4' = 1'-0' SF04552A A JACE T ■ .Mobile- SF552 HWY 85 & 5TH ° 20401 STEVENS CREEK BLVD DATE: T� k—J 1755 CREEKSIDE OAKS DRIVE TE CA CUPERTINO, CA 95014 SACRAMEENNTO, 95833 RHONE: (916) 343—agOO i._ FAX (916) 643—a910 REVIllib B 'Yyq SITE LAYOUT ,MARPWZ JR. SW* 3780 COMMERCE DR W SACRAMENTO, CA 95691 2 (916) 376-8585 REVISION: A -a ! MT MWCOK L.P. CN 3911 CABINET ON 3911 MOUNTING BRACKETS FASTENED TO SUPPORT BRACKETS W/ A -20 SCREWS HORIZONTAL SUPPORT BRACKET VERTICAL SUPPORT BRACKET GALV UNISTRUT PIOOt TYP CONDUIT SPACERS UAW CABINET MOUNTED TO SUPPORT BRACKETS W/ A-20 SCREWS UAW W/ MOUNTING BRACKET TYP WN UNISTRUT P2072SO 1 POST BASE OR EDUIV I I Ph* SMPSOR WEDGE ALL I W/ 2T YN EMBEDMENT I I I ZA- WN .t FRONT VIEW SIDE VIEW CN3911 & LAM H -FRAME MOUNTING DETAIL 1 ,._6. _ 7(16.1•)-1 T0P VIEW � (6..•) O (17.2 ) FRONT VIEW SIDE VIEW CCN 3911 DETAIL J ,•_1• I I I I LJ J• n HORIZONTAL UWSIRUT SHARD BE BETWEEN 13• t 23• WANT I 1 I I (10• IS PREFERRED) NOh WOWING CLEARANCES ABOUT ELECTRICAL EQUIPMENT BE PF11 ABT 11016(E. LENGTH AS REOUNED CONDUIT SPACERS UAW CABINET MOUNTED TO SUPPORT BRACKETS W/ A-20 SCREWS UAW W/ MOUNTING BRACKET TYP WN UNISTRUT P2072SO 1 POST BASE OR EDUIV I I Ph* SMPSOR WEDGE ALL I W/ 2T YN EMBEDMENT I I I ZA- WN .t FRONT VIEW SIDE VIEW CN3911 & LAM H -FRAME MOUNTING DETAIL 1 ,._6. _ 7(16.1•)-1 T0P VIEW � (6..•) O (17.2 ) FRONT VIEW SIDE VIEW CCN 3911 DETAIL J ,•_1• (16.2•) --,/ I I I I LJ J• n LJ J Y--WIB•� TOP VIEW I I FUTILITY H -FRAME DETAIL NOh WOWING CLEARANCES ABOUT ELECTRICAL EQUIPMENT BE PF11 ABT 11016(E. LENGTH AS REOUNED CABINET I I 1 E"MENT CABINET MEAGTED S MINIM M CLEARANCE. MEASURED JO NA MINIMUM SH INCHES FROM BUIL Y mE CLEARANCE, 36 REFS SIDE VIEW UAM DETAIL 4 1._,• I 1 I I I POST LENGTH AS REQUIRED FROM THE GROUND TO A PONT a fJf'. 1■IfiD DOORS SHALL IYK11 NI DEGREES IEIILNIY. U PONT OF EDDOOS 90 DE MINIMUM. CABINET MOUNTING DETAILS VE1S FASTENED TO SUPPORT KETS W/ JI -20 SCREWS TYP J'-0' (8' MAX) ICAL SUPPORT BRACKET END CAP fOR PPE TAP UNISTRUT PIOOI TYP STEEL UNISTRUT STRAPP/N 20 DR ISSUE STATUS- EOLAV AS OCCURS NF DALE OESC2WPRQi BY 01 -IB -10 EXI�IT GAIV MS. T - - - - - - WIT SPACERS P1001 TYP DRAMN BY: K. SAAISO — CHECKED BY: L HOUGHTBY 8 MAX APPROVID BT: DAIS 6/10 ';' ',I' 55¢e OW GALV STD PIPE POST TYP a. of • �qW 5�1! t GRADE OR SLAB _,ALL 3EE 9F (16.2•) --,/ I I I I LJ J• n LJ J Y--WIB•� TOP VIEW I I FUTILITY H -FRAME DETAIL I I Of BOLT, SPRING LENGTH AS REOUNED I I NUT, W WASHER I I I 1 E"MENT CABINET FRONT VIEW SIDE VIEW UAM DETAIL 4 1._,• "LII._iIlli aIIIF ,� RAgEa� I I y PPE POST E00TING Of.. 9 {3till I I I L I r I I I I LJ J• n LJ J Y--WIB•� FRONT VIEW I I FUTILITY H -FRAME DETAIL I I Of BOLT, SPRING LENGTH AS REOUNED SIDE VIEW 3v' a) 0 ■ ■ SHWTnLE: H—FRAME MOUNTING DETAILS sr*0WAeM 1 OF 3 VERTICAL MOUNTING BRACKET PROVIDED BY CABINET 77 MAN ACTURFR ISTRUT U■P1000 IOP I I k BOTTOM YIN I I Of BOLT, SPRING LENGTH AS REOUNED I I NUT, W WASHER I I I 1 E"MENT CABINET I 1 � PEA PLAN PER 1 I UWSTRUT PI000 H -FRAME I 1 I I I POST LENGTH AS REQUIRED I I I I I I I I I I I I 1 CABINET I I I I MOUNTING DETAIL 3v' a) 0 ■ ■ SHWTnLE: H—FRAME MOUNTING DETAILS sr*0WAeM 1 OF 3 CITY OF UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: PERMIT # 0 o BUSINESS LICENSE # OWNER'S NAME: PHONE # 1 4 2? GENERAL CONTRACTOR: T�' — c "'L FAX # I am not using any subcontractors: 3)10)11-0 Signature Daie 'Dip— -UpA, �,,,,i;��HtA �„t,��„+,�a�+�r� ar,�l rnmnlete the following information: 1 1GLI0G 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