B-2016-1511CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1511
20589 HOMESTEAD RD CUPERTINO, CA 95014-0450 (323 36 019)
JFC CONSTRUCTION
INC
MARTINEZ, CA 94553
OWNER'S NAME:
DATE ISSUED: 05/26/2016
OWNER'S PHONE:
PHONE NO: (
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class GENERAL ENGINEERING CONTRACTOR Lic. #59 fi2
X BLDG ELECT PLUMB
Contractor JFC CONSTRUCTION INC Date 12/31/2017
— — —
MECH RESIDENTIAL X COMMERCIAL
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.
JOB DESCRIPTION:
VERIZON - INSTALL NEW WIRELESS TELECOMMUNICATION
I hereby affirm under penalty of perjury one of the following two declarations:
FACILITY - (I) ANTENNA, (I) EQUIPMENT CABINET, (N)RRVS
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
REV#1 - REVISED TYPE OF ASSUMED WALL FROM CMU TO WALL
performance of the work for which this permit is issued.
FRAME SUPPORTING ANTENNA. ISSUED 6/13/16
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: $50000.00
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
Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
23 36 019
3 23
A-1
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature�/ Date
Issued by: Abby A ende
Date: 05/26/2016
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date:
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as deemed by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner o authorized agent:!
APPLICANT CERTIFICATION
Date: 6119116
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1511
20589 HOMESTEAD RD CUPERTINO, CA 95014-0450 (323 36 019)
JFC CONSTRUCTION
INC
MARTINEZ, CA 94553
OWNER'S NAME: CUPERTINO 10 O F ASSN #70
DATE ISSUED: 05/26/2016
OWNER'S PHONE:
PHONE NO: (
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class A B Lic. #592562
Contractor JFC CONSTRUCTION INC Date 12/31/2017
X BLDG —ELECT —PLUMB
MECH RESIDENTIAL X COMMERCIAL
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.
JOB DESCRIPTION:
VERIZON - INSTALL NEW WIRELESS TELECOMMUNICATION
I hereby affirm under penalty of perjury one of the following two declarations:
FACILITY - (N) ANTENNA, (N) EQUIPMENT CABINET, (N)RRVS
1. Ihave 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
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
323 36 019
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature./ V Date 5/26/2016
Issued by: Abby A, e�
calw
�D,.. •• ��flfl --
Date:05/26/2016
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
r. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 5/26/2016
1 hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent•
APPLICANT CERTIFICATION
Date: 5/26/2016
1 certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Signature Date 5/26/2016
Licensed
Professional
Page 1
Waterford Consultants, LLC ● 201 Loudoun Street Southeast Suite 300 ● Leesburg, Virginia 20175 ● 703.596.1022
General Summary
Verizon Wireless has contracted Waterford Consultants, LLC to conduct a Radio Frequency Electromagnetic
Compliance assessment of the proposed Deanza & Homestead site located at 20589 Homestead Road,
Cupertino, CA 95014. This report contains information about the radio telecommunications equipment to be
installed at this site and the surrounding environment with regard to RF Hazard compliance. This
assessment is based on installation designs and operational parameters provided by Verizon Wireless.
The compliance framework is derived from the Federal Communications Commission (FCC) Rules and
Regulations for preventing human exposure in excess of the applicable Maximum Permissible Exposure
(“MPE”) limits. At any location at this site, the power density resulting from each transmitter may be
expressed as a percentage of the frequency-specific limits and added to determine if 100% of the exposure
limit has been exceeded. The FCC Rules define two tiers of permissible exposure differentiated by the
situation in which the exposure takes place and/or the status of the individuals who are subject to exposure.
General Population / Uncontrolled exposure limits apply to those situations in which persons may not be
aware of the presence of electromagnetic energy, where exposure is not employment -related, or where
persons cannot exercise control over their exposure. Occupational / Controlled exposure limits apply to
situations in which persons are exposed as a consequence of their employment, have been made fully aware
of the potential for exposure, and can exercise control over their exposure.
In situations where the predicted MPE exceeds the General Population threshold in an accessible area as a
result of emissions from multiple transmitters, FCC licensees that contribute greater than 5% of the
aggregate MPE share responsibility for mitigation.
Based on the computational guidelines set forth in FCC OET Bulletin 65, Waterf ord Consultants, LLC has
developed software to predict the overall Maximum Permissible Exposure possible at any particular location
given the spatial orientation and operating parameters of multiple RF sources. These theoretical results
represent worst-case predictions as emitters are assumed to be operating at 100% duty cycle.
Radio Frequency Emissions Compliance Report For Verizon Wireless
Site Name: Deanza & Homestead Site Structure Type: Rooftop
Address: 20589 Homestead Road Latitude: 37.337776
Cupertino, CA 95014 Longitude: -122.034417
Report Date: August 28, 2015 Project: New Build
Frequency
Limits for General Population/
Uncontrolled Exposure
Limits for Occupational/
Controlled Exposure
Power Density Averaging Time Power Density Averaging Time
(MHz) (mW/cm2) (minutes) (mW/cm2) (minutes)
30-300 0.2 30 1 6
300-1500 f/1500 30 f/300 6
1500-100,000 1 30 5 6
Deanza & Homestead-New Build 082815
Page 2
Waterford Consultants, LLC ● 201 Loudoun Street Southeast Suite 300 ● Leesburg, Virginia 20175 ● 703.596.1022
For any area in excess of 100% General Population MPE, access controls with appropriate RF alerting
signage must be put in place and maintained to restrict access to authorized personnel. Signage must be
posted to be visible upon approach from any direction to provide notification of potential conditions within
these areas. Subject to other site security requirements, occupational personnel should be trained in RF
safety and equipped with personal protective equipment (e.g. RF personal monitor) designed for safe work in
the vicinity of RF emitters. Controls such as physical barriers to entry imposed by locked doors, hatches and
ladders or other access control mechanisms may be supplemented by alarms that alert the individual and
notify site management of a breach in access control. Waterford Consultants, LLC recommends that any
work activity in these designated areas or in front of any transmitting antennas be coordinated with all
wireless tenants.
Analysis
Verizon Wireless proposes to install one (1) panel-type antennas oriented toward 180 degrees. The antenna
will mounted on the building wall 16 feet above ground level. From this site, Verizon Wireless will enhance
voice and data services to surrounding areas in licensed 700 1900 and 2100 MHz bands. The Effective
Radiated Power (ERP) in any direction will not exceed 6,878 Watts. No co-located antennas are known to
be operating near this site.
Power density decreases significantly with distance from any antenna. The panel-type antennas to be
employed at this site are highly directional by design and the orientation in azimuth and mounting elevation,
as documented, serve to reduce the potential to exceed MPE limits at any location other than directly in front
of the antennas. For accessible areas at the roof level, the maximum predicted power density level resulting
from all operations is 0.1983% of the FCC Occupational limits (0.9915% of the FCC General Population
limits). For accessible areas at ground level, the maximum predicted power density level resulting from all
operations is 40.712% of the FCC General Population limits.
When power density resulting from all Verizon Wireless operations exceeds 5% of the FCC General
Population limits, Verizon Wireless is obligated within this area to mitigate any location where the cumulative
power density due to the emissions from all RF sources may exceed the FCC General Population limits. To
assess this potential, Waterford Consultants, LLC has utilized FCC database query results and publically
available online sources to estimate the location of fixed wireless antennas within 0.25 miles of this site.
Listed in Appendix A are the assumed operating parameters for antennas installed atop the Cupertino Inn at
10889 N De Anza Boulevard which lies 0.20 miles south of the proposed site. The maximum power density
from these sources near the proposed Verizon Wireless operation is 0.558% of the FCC General Population
limit. Predictive modeling indicates that the cumulative contribution from all operations is 41.27% (=40.712%
+ 0.558%) of the General Population limits at ground level in front of the Verizon Wireless antenna.
Therefore, no accessible areas at ground level will exceed the FCC General Population limits and no
mitigation is required.
Waterford Consultants, LLC recommends posting contact information and RF Guidelines signage that
informs personnel entering the site of basic precautions to be followed when working around antennas.
Any work activity in front of transmitting antennas should be coordinated with Verizon Wireless.
Deanza & Homestead-New Build 082815
Page 3
Waterford Consultants, LLC ● 201 Loudoun Street Southeast Suite 300 ● Leesburg, Virginia 20175 ● 703.596.1022
Figure 1: Antenna Locations
Compliance Statement
Based on information provided by Verizon Wireless and the mitigation action to be implemented by Verizon
Wireless, the installation proposed by Verizon Wireless at 20589 Homestead Road, Cupertino, California will
be compliant with Radiofrequency Radiation Exposure Limits of 47 C.F.R. § 1.1307(b)(3) and 1.1310.
Certification
I, Michael A. McGuire, am the reviewer and approver of this report and am fully aware of and familiar with the
Rules and Regulations of both the Federal Communications Commissions (FCC) and the Occupational Safety
and Health Administration (OSHA) with regard to Human Exposure to Radio Frequency Radiation, specifically
in accordance with FCC’s OET Bulletin 65. I have reviewed this Radio Frequency Exposure Assessment report
and believe it to be both true and accurate to the best of my knowledge.
Deanza & Homestead-New Build 082815
Page 4
Waterford Consultants, LLC ● 201 Loudoun Street Southeast Suite 300 ● Leesburg, Virginia 20175 ● 703.596.1022
Appendix A: Assumed Operating Parameters for Nearby Operators
Operator
Freq
(MHz)
ERP
(W)
Antenna
Model
Rad
Center
(ft)
Gain
(dBd)
Orientation
(Deg)
Horizonta
l Beam
Width
(Deg)
AT&T Mobility 700 2000 Panel 25 13.6 340 72
AT&T Mobility 850 2000 Panel 25 13.92 340 67
AT&T Mobility 1900 2000 Panel 25 15.69 340 59
AT&T Mobility 2100 2000 Panel 25 16.44 340 60
Sprint Nextel 850 2000 Panel 25 13.92 340 67
Sprint Nextel 1900 2000 Panel 25 15.69 340 59
Sprint Nextel 2500 2000 Panel 25 16.44 340 60
T-Mobile 700 2000 Panel 25 13.6 340 72
T-Mobile 1900 2000 Panel 25 15.69 340 59
T-Mobile 2100 2000 Panel 25 16.44 340 60