15080094CITY OF CUPERTINO BUILDING PERMIT
WILDING ADDRESS: 10900 N BLANEY AVE
DWNEWS NAME: PACIFIC GAS AND ELECTRIC CO
OWNER'S PHONE: 9252706171
LICENSED CONTRACTOR'S DECLARATION
License Class' Li.. # 3 3
Contractor C DatetC7 2- c
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:
1. 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.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
ction 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 regu�ll 'o up e ino Municipal Code, Section 9.18.
SiQnatur i[' Date lO
0 OWNER -BUILDER DECLARATION
CONTRACTOR: MIR ELECTRIC
P 0 BOX 668
MORGAN HILL, QA 95038
PERMIT NO. 15080094
DATE ISSUED: 10/29/2015
PHONE NO: (408) 846-6300
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL Q
PG&E SERVICE CENTER - INSTALL 4 (N) EV CHARGING
STATIONS
hereby affirm that I am exempt from the Contractor's License Law for one of
he following two reasons:
I, 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)
?. I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (See.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three declarations:
1. 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.
2. 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 r
permit is issued.
3. 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.
Sq. Ft Floor Area:.. ' Valuation: $50000
AP,N Number: 31603045.00 Occupancy Type:
PERMIT; EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DA�S FR LED INSPECTION.
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.
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.
Sienaurre Date__._________—
Signature of Applicant:
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(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants asdefined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety; Code, Sections 25505, 25533, and 25534.
Date: tJ 2 f,5
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 Address
ARCHITECT'S DECLARATION
I understand my; plans shall be used as public records.
Licensed Professional
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 •building cugerlino.Org_
C<UPF-RT1140
PROJECT ADDRESS 10 l co l3- stave AJ L APN R O (,j�-
( V E-MAIL
PON'E
OWNERNAME P/_ 1 I -2,90141 ?-1
STREET ADDRESS / foo A I • ®J„� CITY, STATE, ZIP u Y J 1,^ a.pl I FAX
CONTACT DAME Cit /tie 1 PHOh j ]^Q -t G� [ 4 -74 E-MAIL MIC a� � mi r elecAh C64
STREET ADDRESS CITY, 'r 75-0 fl F g l _ (o S'��
Hd
ra
❑ 00.R4ER ❑ OWNER -BUILDER ❑ OWN'ERAGENT 4'CONTi2ACTOR ❑ CONfRACTORAGENTI I] ARC=1CT ®ENGn'TER ❑ DJ EVE ❑ TENANT
LICENSE NUMBER p !� LICENSE TYPE rt
► 1 C(BUS. LIC n
CONTRACTORNAME I _ c 4' 4� r l� o -t t 39 C tv
COT:PANYNAD4E 1770 £-MAIL 1`°l� Gi1 If�t LtnC. fK +o 8 (. ^CiS{}6
�
STREET ADDRESS Q �QX P g CITY, STATE, ZIP J (/ C J} 62p PHONE 4 08-q 65- 9
ARCMTECTIENGINEER NAME
j �j LICEASE NUMBER ( [ L I �U � BUS. LIC R
COMPAIN'Y NAME
E-MAIL FAX
CITY, STATE, ZIP PHONE
STREET ADDRESS
USE OF EDSFD or Duplex [I 1�4ulti-Family
PROJECT IN WILDLAND PROJECT IN
INTERFACE AREA E!YeS P-"" FLOOD ZONE. ❑ Yes O
STRUCTURE: ❑ Commercial
i
/ 13 SOLAR WATER HEATING El OTHER:
SOLAR PANELS &,ELECTRIC VEHICLE CHARGING STATION
KILOWATTS (COMMERCIAL TOTAL VALUATION:b 000
FOR SOLAR PANELS: NUMBER OF PANELSlU,1ITS:
DESCRIPTION OF WORK �j�� � attCkbCZ ® kAl l I fig
_tel. ..
erty
1 read this
Eordinances
below, I certify to each of the followiI have read the DescriptionOwner or authorized agent to act on the ofof Work and venfj+ rt is accurae.pI eiune eha�f rth all applicable local
applicationthe information I have provided is correct.
tate laws relating to b ']din cti n. I rize re esentatives of Cupertino toenter the aboident dpr ty for inspection purposes.
plicant/Ag _
Dater
SUPPLEMENTALTI\IFO A4�.TIONREQUIRED gzkTc�v�Eo.LY
-
� r ,
PY.4pp 2011.doc revised 03116111
'�7
CITY OF CUPERTINO
TlT.1T Trinrlwmx A T/l77 D7T7TTTN!`_. TiTVTCT(1N
I A:IL 1J1.71 A111A1
f c;h. E lain Cher.."',
ADDRESS: 109020 N BLANEY AVE
.`r. f j.,LIF
DATE: 08/1212015
REVIEWED BY:
MELISSA
Lmi
APN: 316 03 045BP#:
VALUATION:
$50,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Buildin g
Alec Per mi 1,ee:
PENTAMATION SOLAR -COMM
PERMIT TYPE: i
USE:
(,)Iher' P v nb
rruv
WORK
PG&E SERVICE CENTER - INSTALL 4 N EV CHARGING STATIONS
OtPer' E -16c. Imp,
SCOPE
, ; .. I'�:?tt fi?. /kS 7. f'C'E'; Insp.Fee':
Ld
i Ii ch. h It, Fe -e: I -
due to Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
f c;h. E lain Cher.."',
.`r. f j.,LIF
"
L{C c, 1,ian C�/Zf'C�C
fe �. Perinit Fee:
I =IldY}Z%7. pe'l mi Fee':
Alec Per mi 1,ee:
tlrher� �lech. Inv)
(,)Iher' P v nb
rruv
OtPer' E -16c. Imp,
, ; .. I'�:?tt fi?. /kS 7. f'C'E'; Insp.Fee':
Ld
i Ii ch. h It, Fe -e: I -
due to Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
.
NOTE: This estimate does not include fees other
These are based on the preliminaryinformation available and are onl
an estimate Contact the Dent or addn'Z into.
District, etc.. fees
FEE ITEMS Lee Resolution 11-053 E, ff. 711113)
FEE QTY/FEE
MISC ITEMS
$0.00 4 #
Alternative Energy System
Plan Check Fee:
Suppl. PC Fee: Reg. Q OT
Q.0
hrs
$0.00 $436.00
ICHRGSTA EV Charging Station
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
construction -Tuv
Administrative Fee:
Work Without Permit? O Yes No
$0.00
Select allon-Residential
Advanced Planning Fee:
$0.00
Building or Structure
0
�
1 rU,,-el Docuyn nlali()n Pees:
$14.00
Select an Administrative Item
Strom Motion Fee: IBSEISMICO
Bldg Stds Commission Fee: 1BCBSC
$2.00
TOTAL I♦~ E:
$452.00
SUBTOTAT ,
$16.00 $436100
Revised: 07/02/2015
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15080094
10900 N BLANEY AVE (316 03 045) GOWAN
CONSTRUCTION
15TH WEST 8 TH
STREET
OWNER'S NAME: PACIFIC GAS AND ELECTRIC CO
OWNER'S PHONE: (408) 279-8787
LICENSED D ONT A TOR'S DECLARATION
License Class A Lic. #
Contractor GOWAN CONSTRUCTION Date 08/31/2016
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:
m. 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.
Signatur �; Date 4.28.17
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
m. I, 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)
7. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
m. 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
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 4.28.17
DATE ISSUED: 10/29/2015
PHONE NO: 209-836-2482
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
PG&E SERVICE CENTER - INSTALL 4 (N) EV CHARGING STATIONS
40 AMPS EA (160 AMPS TOTAL).
REVISION #1: CHANGE CONTRACTOR (GOWAN
CONSTRUCTION); REVISE CLIPPER CREEK CHARGERS AT CM&O
BLDG TO DUAL GFCI OUTLETS (4 TOTAL); RELOCATE CHARGERS
AT OPERATIONS TO ENGINEERING/ADMIN BUILDING (2 DUAL
AND 1 SINGLE CHARGERS). ISSUED 4.28.17
Sq. Ft Floor Area: I Valuation: $50000.00
APN Number: Occupancy Type:
316 03 045
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: SEAN HATCH
Date: 10/29/2015
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: 4.28.17
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. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) 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 maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent
Date: 4.28.17
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 Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CUPERTINO
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-322.8 • FAX (408) 777-3333 • building(W-cupertino.or4
PROJECT .ADDRESS / 7 / �. A
/
APNo
J v
OWNER NAME /-
ate
�
YHONE � Z70 Gf71
E-MAIL
STREET ADDRESS /v o o jam✓,
CITY, STATE,
<�
CONTACT NAME
PHONE(Zo, UTO
E-MAILGC vc�1� v I I
STREET ADDRESS C (��
CITY, STATE, ZIP- {�` 6q0
El OWNER 11OWNER-BUILDER❑ OWNER AGENT CONTRACTOR 11CONTRACTORAGENT ❑ ARCHITECT ❑(ENGINEER ❑ DEVELOPER ❑ IFNA�11
CONTRACTOR NAME /� �. n / p� '�
v�
LICENSE NUMBER/_ C �y
IJP
LICENSE�TY
BUS. LIC # �z] -7-)
d —
COMPANY NAME /
v k �. z s �✓ a o.+ C_
E-MAIL /_(G
✓1�+7 p .-.
V 't we a, G
FAX
STREET ADDRESSCITY,
/ 57 ►✓ S
STATE, ZJJ:�
PHONE
ZU�
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
S"FREET ADDRESS
CITY, S'FATE, ZIP
PHONE
USE OF ❑ SFD OI Duplex ❑ Multi -Family
STRUCTURE: Commercial
PROJECT IN WILDLAND
URBAN INTERFACE AREA ❑ Yes No
PROJECT IN
FLOOD ZONE ❑ Yes )I No
/
❑ SOLAR PANELS
ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER HEATING
❑ OTHER:
FOR SOLAR PANELS: N.UMBFI1 OF P.ANELS/UNITS: KILOWATTS (COMMERCIAL ONLY):
TOTAL VALUATION:
��
DESCRIPTION OF WORK I /
/C.Lyt,j /O /L
RECEIVED BY:
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to nstpx . authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: — Z —
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
OVER-THE-COUNTER
1
❑ EXPRESS
U
U
-
❑ STANDARD
-
❑ LARGE
0.
❑ MAJOR
PVApp_2011.doc revised 03116111
A
`J, Z
SAFETY. RELIABILITY. INNOVATION. ANTICIPATION. If you're looking for the s
most reliable and affordable EVSE charge station, then ClipperCreek is the smart4
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self -check feature that eliminates the need for monthly testing by user.
• Service Ground Monitor: Constantly checking for presence of proper safety ground.
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CODES, STANDARDS AND RECOMMENDED PRACTICES
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UL 1998 Standard for Safety Related Software
UL 991 Standard for Tests for Safety -Related Controls Employing Solid -State Devices
NEC 625 Electric Vehicle Charge System
SAE -11772 Electric Vehicle Conductive Charge Coupler
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A
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CT4000 Family
ChargePoint` Charging Stations
The CT4000 is the latest generation of ChargePoint charging Driver Friendly User interface
stations. Refined yet rugged, the CT4000 family sets the + Instructional video shows how to use the station
industry standard for functionality and aesthetics. A robust cord + Multi -language: English, French, Spanish
retraction system comes standard on all CT4000 models to + Touch button interface; works in rain, ice and with gloves
eliminate unsightly cords on the ground, and to keep your drivers
from having to touch charging cables. + Backed by ChargePoint's world class 24/7/365 driver
phone support
The CT4000 full motion color LCD display instructs drivers while
supporting dynamic updates of custom branded videos and
advertisements.
The intelligent power sharing feature of the CT4000 doubles
the number of parking spaces served by allowing two charging
ports to share a single circuit. Sites with single port EV stations
can upgrade to dual port stations without requiring additional
electrical services.
All CT4000 models offer one or two standard SAE J1772'"
Level 2 charging ports with locking holsters, each port supplying
up to 7.2kW.
Available in bollard and wall mount configurations, the CT4000
supports easy installation anywhere. To future proof your invest-
ment, all stations are fully software upgradeable over the air.
Corporate Branding and Video Advertising
+ Download full motion color videos to your stations'
+ Custom replaceable signage to project your brand
+ Custom "helmet" printing available'
Intelligent Power Sharing (patent pending)
+ Reduced installation and operating costs
Dynamically share one 40A circuit between two parking
spaces
Double the number of parking spaces for a given site's
power capacity
Upgrade a single port station to dual port with no
electrical upgrade
Cord Management
+ Keep charging cords off the ground and out of drivers hands
+ Standard on all models
Ultra -reliable second -generation gravity operated mechanism
Flexible over entire -22°F to +122°F product temperature range
' Download fees apply
2 Minimum order quantities apply
Energy Measurement and Management
+ Real-time energy measurement
+ 15 minute interval recording
+ Time of Day (TOD) pricing
+ Load shed by % of runn
or to fixed power outpi
The standard EV Charging Or
sign is easily replaceable witf
your branding.
The cap of the CT4000 famil
also available for custom
branding.
The 5.7° LCD display provide!
full motion charging
instructions in a clear and
simple format. It also allows
station owners to deliver
advertising messaging.
Driver interaction is
supported in any weather
by five rugged. back -lit
buttons with audio feedback.
�ChargePanint CT4000 Family
3.5"
(88 mm)
13.7'
(347 mm)
9.1" _
(232 mm)
71.3"
(1811 mm)
46.7"
(1186 mm)
2 chargepoint.com
9.2" ---
(233 mm)
71.3"
(1810 mm)
13.7"
(347 mm)
11.8"
(300 mm)
46.6"
(1184 mm)
Ir
19.0"
(483 mm)
CT4000 Family Specifications
Electrical Input
AC Power Input Rating - Standard
AC Power Input Rating - Power Sharing
Input Power Connections - Standard
Input Power Connections - Power Sharing
Required Service Panel Breaker - Standard
Required Service Panel Breaker - Power Sharing
Service Panel GFCI
Wiring - Standard
Wiring - Power Sharing
Station Power
-chargepoin+
Single Port Dual Port
208/240VAC 60Hz single phase @ 32A
208/240VAC 60Hz single phase @ 32A x 2
n/a
208/240 VAC 60Hz single phase @ 32A
One 40A branch circuit
Two independent 40A branch circuits
n/a
One 40A branch circuit
40A dual pole (non-GFCI type)
40A dual pole (non-GFCI type) x 2
n/a
40A dual pole (non-GFCI type)
Do not provide external GFCI as it may conflict with internal GFCI (CCID)
3 -wire (1-1, L2, Earth)
5 -wire (Ll, Ll, L2, L2, Earth)
n/a
3 -wire (Ll, L2, Earth)
8W typical (standby), 15W maximum (operation)
Electrical Output
AC - Standard 7.2kW (240VAC @ 30A) 7.2kW (240VAC @ 30A) x 2
AC - Power Sharing n/a 7.2kW (240VAC @ 30A) x 1 OR
3.8kW (240VAC @ 16A) x 2
Functional Interfaces
Connector(s) Type SAE J17721" SAE J1772'" x 2
Charging Cable Length 18' (5.5 meters) 18' (5.5 meters) x 2
Overhead Cable Management System Yes
LCD Display 5.7" full color, 640x480, 30fps full motion video, active matrix, UV protected
Card Reader ISO 15693,14443, NFC
Locking Holster Yes Yes x 2
Safety and Connectivity Features
Ground Fault Detection
20mA CCID with auto retry
Open Safety Ground Detection
Continuously monitors presence of safety (green wire) ground connection
Plug -Out Detection
Power terminated per SAE J1772'" specifications
Power Measurement Accuracy
+/- 2% from 2% to full scale (32A)
Power Report/Store Interval
15 minute, aligned to hour
Local Area Network
2.4 GHz Wi-Fi (802.11 b/g/n)
Wide Area Network
3G GSM, 3G CDMA
Safety and Operational Ratings
Enclosure Rating
Type 3R per UL 50E
Safety Compliance
UL listed for USA and cUL certified for Canada; complies with UL 2594, UL 2231-1, UL 2231-2,
and NEC Article 625
Surge Protection
6kV @ 3000A. In geographic areas subject to frequent thunderstorms, supplemental surge
protection at the service panel is recommended.
EMC Compliance
FCC Part 15 Class A
Operating Temperature
-22°F to 122°F (-30°C to +50°C)
Operating Humidity
up to 85% @ +50°C (122°F) non -condensing
Non -Operating Humidity
up to 95% @ +50°C (122°F) non -condensing
Terminal Block Temperature Rating
221°F (105°C)
Maximum Charging Stations per 802.11 Radio Group
10. Each station must be located within 150 feet "line of sight" of a gateway station.
ChargePoint, Inc. reserves the right to alter product offerings and specifications at any time without notice,
and is not responsible for typographical or graphical errors that may appear in this document.
chargepoint.com 3
ChargePoint CT4000 Family
CT4021 Bollard charging station
CT4023 Wall Mount
charging station
—chargepoirl+
ChargePoint, Inc.
1692 Dell Avenue I Campbell, CA 195008-6901 USA
+1.408.370.3802 or toll free 877.370.3802
chargepoint.com
Ordering Information
Specify model number followed by the applicable code(s).
The order code sequence is:
Model -Options -Warranty
Model Single Port Bollard Mount
CT4011
Dual Port Bollard Mount
CT4021
Single Port Wall Mount
CT4013
Dual Port Wall Mount
CT4023
Options Integral Gateway Modem - USA
-GWI
Integral Gateway Modem - Canada
-GW2
Warranty Parts Only Extended Warranty - CT4000-EWn'
2, 3, 4, or5year
' Substitute n for the duration of the warranty (2, 3, 4, or 5 year)
Order Code Examples
orderingIf this the order code is
Dual Port Bollard Mount USA Gateway Station CT4021-GW1
Single Port Wall Mount Station with CT4013
5 Year Warranty CT4000-EW5
Dual Port Wall Mount Canada Gateway Station CT4023-GW2
with 2 Year Warranty CT4000-EW2
For More Information
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registered logo mark of ChargePoint, Inc. All other products or services mentioned are the trademarks, service marks, registered
trademarks or registered service marks of their respective owners. Sept 2014 PN 73-001020-01-5
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