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BLD-2019-1179BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10101 N DE ANZA BLVD CUPERTINO APN: 326 34 071 PERMIT NO: BLD-2019-1 179 CONTRACTOR: WALKER CELLULAR INC, 150 FLOCCHINI CIRCLE LINCOLN CONTRACTOR PHONE: DATE ISSUED 8/14/2020 12:53:58 PM ISSUED BY: Sean Hatch VALUATION: $15000 JOB DESCRIPTION COVID-19 EP - AT&T CCL00737 - REMOVE (3) EXISTING RRUS 11 B5 ON ROOFTOP TYP. (1) PER SECTOR; REPLACE (3) EXISTING RRUS; 11 B12 RRUS ON ROOFTOP FOR (3) PROPOSED 4449 RRUS TYP. (1) PER SECTOR INSTALL (1) 6630 BBU IN AN EXISTING RACK IN THE EQUIPMENT AREA LICENSED CONTRACTOR DECLARATION CONTRACTOR: WALKER CELLULAR INC LICENSED CLASS: C-7 LOW VOLTAGE SYSTEMS, C1 0 ELECTRICAL, B GENERAL BUILDING CONTRACTOR LICENSED NO: 954113 EXP DATE: 1 1 /30/2020 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 penatiy of perjury one of the following three declarations: le 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. V 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 comply 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 with such provisions or this permit shall be deemed revoked. HAZARDOUS MATERIALS DISCLOSURE le 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 Municipal or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. EPA LEAD -SAFE DISCLOSURE An EPA Lead -Safe Certified Renovator will be responsible for this project. Certified Firm Name: V No EPA Lead -Safe Certified Firm is required for this project. Firm Certification No: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code). Yes V No Lender's Name: Lender's Address: APPLICATION 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, judgements, 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. .— Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 365 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 365 days after the time the work is commenced.