Fillable Wireless Telecommunications Facility Permit Application (City of Long Beach California)

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Wireless Telecommunications Facility Permit Application (City of Long Beach California)

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October 2020 version
Wireless Telecommunications Facility Permit Application
Project Address: ______________________________________________ Long Beach, CA 908 ____
Agent Name: ____________________________________________ Ph: _________________________
Agent Company: _________________________________________ Fax: ________________________
Mailing Address: ______________________________________________________________________
City: _____________________________ State: _____ ZIP: _______ Email: ______________________
Agent Signature: ____________________________________ Title: _____________________________
Wireless Carrier Name:_________________________ Corporate Rep.:__________________________
Mailing Address: ______________________________________________________________________
City: _____________________________ State: _____ ZIP: _______ Ph: ________________________
This project is a: New wireless telecom facility where none currently exists
New co-location for this carrier at another carrier’s existing wireless telecom facility
Modification to this carrier’s existing wireless telecom facility at this site
This site is: Roof/building mounted, or electrical transmission tower-mounted (a “base station”)
Monopole- or other radio tower-mounted (a “tower”)
Other (explain): _______________________________________________________
(As “base station” and “tower” are defined in Section 1.40001(b)(1) and (9) of 47 CFR Part 1 Subpart CC)
Will this project cause a “substantial change” to an existing facility? Yes No N/A
(As “substantial change” is defined in Section 1.40001(b)(7) of 47 CFR Part 1 Subpart CC)
Is this an “eligible facilities request” under Section 6409(a) of the Spectrum Act? Yes No
(As “eligible facilities request” is defined in Section 1.40001(b)(3) of 47 CFR Part 1 Subpart CC)
Which “shot clock” applies to this application?
60-day “deemed granted” shot clock under Section 6409(a) of the Spectrum Act
90-day shot clock under Section 332(c)(7) of the Communications Act
150-day shot clock under Section 332(c)(7) of the Communications Act
Other or none (explain) __________________________________________________
See application submittal requirements on the next page and attach all required items. If this application is an
eligible facilities request, you should submit for building and electrical plan check immediately.
BELOW THIS LINE FOR STAFF USE ONLY
Required Permits:
Building/Electrical only
Administrative Review
Wireless SPR
CUP
Application No.: ___________
Subtype No.: ___________
Project (Infor) No.: ___________
CEQA No. ___________
Filing Date: __________
Received by: __________
Assigned Planner: __________
Council District: __________
All Planning applications for any work at a wireless telecommunications facility must be submitted using this
form. Applications submitted on other forms will not be accepted.
Applications are accepted by appointment only. Call (562) 570-6194 to schedule.
Development Services
Planning Bureau
411 W. Ocean Boulevard, 2nd Floor, Long Beach, CA 90802
562.570.6194 | longbeach.gov/lbds
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City of Long Beach | Planning Bureau
411 W. Ocean Blvd., 3
rd
Floor Long Beach, CA 90802 (562) 570-6194 longbeach.gov/lbds
October 2020 version
Submittal Requirements for Wireless Telecom Applications
This list contains the application requirements for Planning permits (entitlements) for wireless telecom
applications. Separate materials are required for submittal to plan check with Building & Safety. Please
contact Building & Safety at (562) 570-6651 to determine their application requirements for plan check.
Required for All Wireless Applications:
Wireless Telecom Application form
Letter of Authorization from Carrier to Vendor
Property Owner Permission, consisting of one of the following:
Letter of Authorization from Property Owner (this must be from the owner
or property management company, and not from a lessee, i.e. tower
management company, etc.), or
Copy of Carrier’s Lease showing that carrier has explicit authorization to
make alterations to the site without further property owner approval.
Additional Materials:
Site Plan Review Committee Approval (existing sites and new co-locations only)
Electronic plans (pdf format)
Photo-simulations (pdf format), with at least 3 views of the site. If no exterior visible
work is proposed, photographs of the site may be substituted.
RF report prepared by 3
rd
party RF engineering consultant showing the site will
comply with FCC regulations. This may be submitted after the final site design is
established to avoid the need to revise the report.
Planning Commission Approval (new-build sites only)
Preliminary Title Report for subject property
Electronic plans (pdf format)
Photo-simulations (pdf format) with at least 3 views of the site.
Coverage and propagation maps (pdf format).
Detailed alternatives analysis explaining options for co-location instead of a new-
build site and discussing feasibility of each option.
List and map of all existing sites (by all carriers) within a mile of the proposed site—
best effort due diligence is required.
List and map of all on-air sites in Long Beach belonging to the subject carrier.
RF report prepared by 3
rd
party RF engineering consultant showing the site will
comply with FCC regulations. This may be submitted after the final site design is
established to avoid the need to revise the report.
Environmental Assessment form (available on www.longbeach.gov/lbds/forms/
).
These application requirements are subject to change and may be updated periodically at the discretion of
the Zoning Administrator. If you have any questions about the application requirements, please call the
Zoning Information Line at (562) 570-6194 prior to submittal.
To request this information in an alternative format or to request a reasonable accommodation, please contact the
Development Services Department at longbeach.gov/lbds and 562.5
70.3807. A minimum of three business days is
requested to ensure availability; attempts will be made to accommodate requests with shorter notice.
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Wireless Telecommunications Facility Permit Application (City of Long Beach California)

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Completed 23 January 2021

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