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14070038CITY OF C'><,TIPIER'>I INO BUILDING PERMIT BUILDING ADDRESS: 10431 N DE ANZA BLVD CONTRACTOR: CUPERTINO ELECTRIC PERMIT NO: 14070038 INC OWNER'S NAME: APPLE COMPUTER INC 1132 N 7TH ST DATE ISSUED: 08/08/2014 OWNER'S PHONE: 4087835395 SAN JOSE, CA 95112 PHONE NO: (408)99 1 -1000 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ /� License Class �� Lie. # ��� "T INSTALLATION OF (5) EV CHARGING STATTIONS CREATING (l ��' / t� (8) STANDARD EV STALLS AND 1 ACCESSIBLE EV STALL Contractors � f(A -, - Date (9) TOTAL \ 1 hereby affirm tlhat I am licensed under the provisions of Chapter 9 �/��^7 y �i tl11bli -1 r ��S ) (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 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 Sq. Ft Floor Area: Valuation: $120000 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 APN Number: 32633114.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating �� ®�� ®� PERMIT �������� ®� to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DA FROM IL ST CALLED IIN�IP OTION. indemnify and keep hazml s the City of Cupertino against liabilities, judgments, costs, and expenses whic nay accrue against said City in consequence of the granting of this ermi . itionally, the applicant understands and will comply Issued by: Date: with all non- o t soi e eg la ions per the Cupertino Municipal Code, Section 9.18. RE- ROOFS: Signature Date 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. ❑ OWNER- BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the deelarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should 1 use equip ent or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay a Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance wgeno Municipal Code, Chapter 9.12 and 1 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 the Health & Safety Code, 25533, and 25534. Owner or authorized agen Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. 1 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date y CtJF'FRf�I �n AL17CG°3NQ7WE ENERGY PER Wiffi APPLI]C A IIOO M COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014 -3255 t(408) 777 -3228 ^ FAX (408) 777 -3333 ^ _ouidirc�f_cuparbno.org 00� " AA1 -mku- PROJECT' ADDRESS 10431 N. DE ANZA BOUCEVARD APV "326.33.114 OWNER NAMEAPPLE COMPUTER INC. PHONF408.783.5395 F -M MI. STREET ADDRESS 1 INFINITE LOOP, MS 47 -18 -DDC clTr. sT.ATE. zip CUPERTINO, CA 95014 FAx CONTACT NAME DEMETRI GONZALEZ PHONF408. 783.5395 F- nI :11ILDEMETRI_GONZALEZ @APPLE.COM STREET ADDRESS 1 INFINITE LOOP, MS 47 -18 -DDC 7`1- Y,STATF, zip CUPERTI NO, CA 95014 FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGLYr ❑ %RCHITIiCT ❑ ENOtNEER ❑ DEVELOPER ❑ rkN 1N "r CONTRACTOR NAME TBD LICFNSF NUp1BE•R LICENSF TYPF BUS LIC++ COMPANY NAME L•' -MAIL FAX STREET ADDRESS CITY. STATE, ZIP PHONE ARCHITECT, ENGINEER NAME MARK KNUDSEN LICENSE NUMBER 75828 BUS LICa 7 COMPANYNAMEKIER & WRIGHT E-MAIL. MKNUDSEN@KIERWRIGHT.COM FAX408327.5641 STREET ADDRESS 3350 SCOTT BLVD. 422 CITY, STATE, LIP SANTA CLARA, CA 95054 1110NE 408.727.6665 CSE OF ❑ SFD Or Duplex ❑ Multi- Fatnily STRUCTURE: ❑ Commercial PROJEC "r IN WILDLAND URBAN INTERFACE ARFA ❑ Yes C NO PROJECT IN FLOOD ZONE ❑ Yes No ❑ SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION I ❑ SOLAR WATFR IMA rING ❑ OTHER. FOR 01_4R PA,NFIS: NUMBER OF PANELS/[ NITS; N KILOWATTS: TOTAL. VA1,UATION. $120,000 DESCRIPTION OF WORM INSTALLATION OF NEW ELECTRIC VEHICLE CHARGING STATIONS, STRIPING OF STALLS AND INSTALLATION OF ASSOCIATED SIGNAGE. 8 STANDARD EV STALLS, 1 ADA EV STALL (9 TOTAL) & 5 CHARGING STATIONS RECEIb ED BY: [By my sienature below. I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf I have read this pplication and the information I have provided is correct. I have read the Description of Wort: and vcrif} i[ is accurate t agee to comply with all applicable local rdinances and state laws relating[, tyildins;con$�uctiW- I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agene „ kN „+ _ Date S P LEMENTAL INFORMATION RL-'QUIRED OFFICE I*S� ONLY `° w c. g L ❑ ONIR- THE - COUNT -ER ❑ CxPRESS ❑ STANDARD ❑ LARGE. ❑ 2a.asaR P1 App 2012.doc revised 06 20 1 MY OF cCUP E][8'II NO FEE IESTMATOR — BUR LIIDRN G IIDEVEMN NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the preliminary information available and are onl an estimate. Contact the Dg et for addn'l in o. ADDRESS: 10431 N. DE ANZA BLVD DATE: 07/90/ 014 I REVIEWED BY: SEAN .j %r1c7 /l. .Pel Pnlr.l'CCZ' APN: iBP #: *VALUATION: 1$120,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRff MARY Commercial Building USE: Plumb. Irlsp. Feu: PENTAMATIION SOLAR -COMM PERMIT TYPE: WORK INSTALLATION OF 5 EV CHARGING STATIONS CREATING 8 STANDARD EV STALLS AND 1 SCOPE ACCESSIBLE EV STALL (9 TOTAL). NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the preliminary information available and are onl an estimate. Contact the Dg et for addn'l in o. :Tech. flan C'hec'k Plumb. Plan Chei'k � !:' /ar.. I'fcm C'ltetk .j %r1c7 /l. .Pel Pnlr.l'CCZ' Plumb. Permit Fee: E/0:. Permit F(,(,: Other Mec-A .1rup. Othex Plumb Insp. C Other i -Jee.. llecp. 7� Mech. hr,y. Fce: Plumb. Irlsp. Feu: Elec. lush. Fee. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the preliminary information available and are onl an estimate. Contact the Dg et for addn'l in o. FEE ITEMS (Fee Resolution 11 -053 a.7/1", 11 FEE QTY/FEE IVIIIISC ITEMS Plan Check Fee: $0.00 = # Alternative Energy System $545.00 ICHRGSTA 7 EV Charging Station Suppl. PC Fee: Q Reg. ® OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.C) Reg. Q OT 10.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construclion :Tax: Aininistralive F(?e: 0 E) Work Without Permit? ® Yes C) No $0.00 Advanced Planniny, Fee: $0.00 Select a Non - Residential (E) Building or Structure G Travel Documentation Fees: (AO Strong Motion Fee: IBSEISMICO Select an Administrative Item B11 Stds Commission Fee: IBCBSC $5.00 SUBTOTALS: $30.20 $545.0011 TOTAL 1FiEE: 5.20 Revised: 07/07/2014 e d o00000 F (COO FY . ChargePoint° Charging Stations The CT4000 is the latest generation of ChargePoint charging D Tpvav FvIe dly Use? C° �'ovl;aze 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 eliminate unsightly cords on the ground, and to keep your drivers ' Touch button interface; works in rain, ice and with gloves from having to touch charging cables. Backed by ChargePoint's world class 24/7 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. All ChargePoint stations are networked and managed through ChargePoint Service Plans' and backed by ChargePoint's world class 24/7 driver phone support. CoPiporate Branding and Video AdvevUsinoj i Download full motion color videos to your station S2 Custom replaceable signage to project your brand Custom "cap" printing available3 wean Cora YechnologyTM ¢ Maintenance -free, light- weight, self- retracting cords come standard on all models Keep charging cords off the ground and out of your and drivers' hands Flexible over entire -22 °F to +122 °F product temperature range Intelllcgent Power Shaving (patent pending) Reduced installation and operating costs Dynamically share one 40A circuit between two parking spaces Energy Mee)SUFe,T Real -time energy measurement 15 minute interval recording Time of Day (TOD) pricing Load shed by % of run or to fixed power outr The standard EVCharging C sign is easily replaceable wil your branding. The cap of the CT4000 fam also available for custom branding. The 5.7" LCD display provid4 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 Double the number of parking spaces for a given site's cUPERTMOO power capacity Upgrade a single port station to dual Building oepla�e� electrical upgrade LODE CWPLIAHG� ChargePoint Service Plans are sold separately i�EViEw��1 rU� � �� . ,¢ a Download fees apply ,✓ ' Minimum order quantities apply RevlPWed By. ` ChargePoint CT4000 Family 13.7" _ (347 mm) 9.2" — C (233 mm) I h 71.1" (1806 mm) chargepoint.com C Y 4023 WE Can o awn G s 3.5" (88 mm) V 11.8" I 16.9" (299 mm) 17.3" (430 mm) (440 mm) 46.7" (1186 mm) _ 13.7" _ (347 mm) 9.2" (233 mm) I oao 71.0" (1805 mm) 46.7" (1186 mm) I I I QJ CT -4000 Fam lly Spedfkatoons 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 Electfta� Input Single Port AC Power Input Rating - Standard 208/240VAC 60Hz single phase @ 30A 208/240VAC 60Hz single phase @ 30 x 2 AC Power Input Rating - Power Sharing n/a 208/240 VAC 60Hz single phase @ 32A Input Power Connections - Standard One 40A branch circuit Two independent 40A branch circuits Input Power Connections - Power Sharing n/a One 40A branch circuit Required Service Panel Breaker - Standard 40A dual pole (non -GFCI type) 40A dual pole (non -GFCI type) x 2 Required Service Panel Breaker - Power Sharing n/a 40A dual pole (non -GFCI type) Service Panel GFCI Do not provide external GFCI as it may conflict with internal GFCI (CCID) Wiring - Standard 3 -wire (LI, L2, Earth) 5 -wire (1-1, L1, L2, L2, Earth) Wiring - Power Sharing n/a 3-wire (LI, L2, Earth) Station Power 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 ConnecVvfty Features Ground Fault Detection Open Safety Ground Detection Plug -Out Detection Power Measurement Accuracy Power Report /Store Interval Local Area Network Wide Area Network Safety and Operational Ratings 20mA CCID with auto retry Continuously monitors presence of safety (green wire) ground connection Power terminated per SAE J1772'" specifications +/- 2% from 2% to full scale (32A) 15 minute, aligned to hour 2.4 GHz Wi -Fi (802.11 b /g /n) 3G GSM, 3G CDMA 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 thunder storms, 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 950/c @ +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 d 'ChargePoint CT4000 Family CT4021 Bollard charging station CT4023 Wall Mount charging station -6ha�F2N�,,, �<7Cl,f70n qrpl C a 0o _'7F, Specify model number followed by the applicable code(s). 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 -GW1 Integral Gateway Modem - Canada -GW2 Warranty Single Port Extended Hardware -Only CT4010 -EXWn' Warranty - 2, 3, 4 or 5 year term Dual Port Extended Hardware-Only CT4020 -EXWn' Warranty - 2, 3, 4 or 5 year term Where n is the total number of years in the term ®PideP Code �-,_7xarn p zs Dual Port Bollard Mount USA Gateway Station CT4021 -GW1 Single Port Wall Mount Station with CT4013 5 Year Warranty CT4010-EXW5 Dual Port Wall Mount Canada Gateway Station CT4023 -GW2 with 2 Year Warranty CT4020 -EXW2 Fov N- mm- Visit chargepoint.com Follow us on Twitter @chargepointnet Like us on Facebook @chargepoint ChargePoint, Inc. Copyright © 2013 ChargePoint, Inc. All rights reserved. CHARGEPOINT is a U.S. registered trademark /service mark, and an EU 1692 Dell Avenue I Campbell, CA 195008-6901 USA registered logo mark of ChargePoint, Inc. All other products or services mentioned are the trademarks, service marks, registered +1.408.370.3802 or toll free 877.370.3802 trademarks or registered service marks of their respective owners. PN 73- 001020 -01 Rev 4 chargepoint.com pr.rted on paper made with 100% post - consumer fibe• and Listed by Underwriters C &US '00% certified renewable energy, and processed chlorine free. Laboratories Inc. USTEp ®R.yaea LaCF Fiber