REQUEST FOR APPROVAL FOR SATELLITE DISH/ANTENNA INSTALLATION JASMINE HEIGHTS HOMEOWNERS ASSOCIATION, INC.

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1 REQUEST FOR APPROVAL FOR SATELLITE DISH/ANTENNA INSTALLATION JASMINE HEIGHTS HOMEOWNERS ASSOCIATION, INC. The Jasmine Heights Declaration of Restrictions and Declaration Establishing a Plan of Condominium Ownership recorded March 31 st, 1999 (CC&Rs) provides in Article 7, Section 7.2 that no improvement of any kind may be installed within the Jasmine Heights condominium project without prior written consent of the Architectural Review Committee. Article 3, Section 3.7 of the CC&Rs provides in part: No television, video or radio poles, antennae, satellite dish, cables or other transmission and/or reception fixtures or personal property (individually and collectively the Antenna Equipment ) shall be installed or maintained on any lot except as provided under definitions. The Federal Communications Commission has adopted regulations pursuant to the Telecommunications Act of 1996 which limit the enforceability of Article 7, Section 7.2 and Article 3, Section 3.7 of the CC&Rs with respect to the installation of certain antennas in the Jasmine Heights subdivision. It is the intent of the Association only to regulate antennas to the extent authorized by the regulations of the Federal Communications Commissions, as they may be amended from time to time. Definitions For the purpose of this policy, antenna means: 1. A dish, an antenna that is one meter (39 ) or less in diameter and is designed to receive direct broadcast satellite service (DBS), including direct-to-home satellite service. 2. Antenna Equipment that is one meter or less in length or diameter or diagonal measurement, provided that the location, color and screening requirements shall be in accordance with any guidelines imposed by the Architectural Committee. Homeowners need to certify that the Antenna proposed for installation meets the requirements for approval. If the Antenna installation does not meet these requirements, the installation request is subject to additional review by the Architectural Committee of Jasmine Heights. See the Guide to Installing Satellite Dishes document on the website for examples of installations that qualify for approval. You may also contact PAS for the guide document. Service Level for Approval: If the Antenna to be installed meets ALL the requirements for approval, this application will be approved within 30 days after receipt by MB Homeowners Management. Antenna installations that do not meet these requirements will be subject to additional review by the architecture committee that could take up to 60 business days. If Antennas are not installed in approved ways or approval is not obtained, significant fines and costs to bring it into compliance with policies will be charged to the homeowners. ADDRESS OF PROPERTY: DATE OF APPLICATION: Description of Work Proposed: Jasmine Heights HOA Satellite Dish Application Revised June 2007 Page 1 of 5

2 Antenna Feature Are you the Homeowner? Homeowner supplied information Circle One: Yes/ No Note: all architectural applications for Antenna installations must be submitted by the condominium owner, rather than tenants, household members or guests. Homeowner has read the Antenna policy of Jasmine Heights and agrees to install the Antenna in compliance with the policy. _ Note: The policy is on the Jasmine Heights website or can be obtained from PAS. How many Antennas will be installed? Note: Only one Antenna can be installed per house to qualify for approval. More than one antenna will be routed to the Architecture committee for approval. One More than one Are any other Antennas owned or operated by the current homeowner or resident? Note: Only one Antenna can be installed per house to qualify for approval. If this current installation is adding to the Antennas already installed, a review by the Architecture committee is required. Circle One: Yes/No Attach a copy of plans for the installation of the Antenna and wiring. Circle One: Plans Attached? Yes/ No Note: Antenna installation contractors frequently will provide such plans to applicants at no additional cost. The plan should be reasonably complete and show the installation location and wiring diagram. Antenna Company Name of Company: Dimensions of Antenna in inches Note: For satellite dishes the Diameter should be less than 39 or 1 meter. Color of Antenna Note: The color of the Antenna should be gray or brown to qualify for approval. Complete one of the following: Diameter of dish is inches Length of antenna is inches Gray Brown Other Jasmine Heights HOA Satellite Dish Application Revised June 2007 Page 2 of 5

3 If it is another color the HOA may require antennas to be painted in a fashion that will not interfere with reception, but that blends the antenna into the background against which it is mounted if the antenna is visible from the street or common area. Alternatively, the HOA may require landscaping or other screening of the antenna, provided that the cost is reasonable. The cabling should be brown (preferred), white or black. Will the Antenna be attached directly to the stucco/ building in any manner? Circle One: Yes/ No Note: The Antenna SHOULD NOT be directly attached to the stucco/building in any manner. The Antenna will be installed on the wooden eaves so that is does not block the view from any window. acceptance: Note: Antennas should never be mounted on the stucco. The SHOULD be mounted on the wooden eaves only. Will the antenna be professionally installed by a licensed professional? Circle One: Yes/No If yes, the name of the company installing the Dish/Antenna: The installation location selected will not unreasonably delay or prevent installation, maintenance or use of antennas in common area. It will not unreasonably increase the cost of the installation, maintenance or use, or preclude reception of an acceptable quality signal. The wires and connecting antennas will be securely attached to structures and not strung openly in the air from one point to another. Homeowners initials to indicate The cable from this antenna will be routed to the existing cable connection point (from where the home cable points are internally wired) Note: This is required for approval. Basically, this means that the cable will not enter the unit but be routed to the cable connection box where the ordinary cable line would have been connected. Jasmine Heights HOA Satellite Dish Application Revised June 2007 Page 3 of 5

4 The installation of this Antenna will not obstruct any other Antenna currently installed by your neighbors. The installation will be securely affixed so as not to present a falling or collapse hazard. _ The Antenna will not impair traffic or pedestrian safety. The Antenna installation will not impair fire escapes or fire aggress paths. The Antenna installation will be installed in accordance with the Uniform Electrical Code requirements for grounding. Note: Verify that the plans submitted with this application clearly show compliance with the requirements for grounding. HOA is not responsible for damage caused by the Antenna from any cause. _ HOA is not responsible for damage to the Antenna unit from any cause including, but not limited to: falling debris, bird droppings, debris during gutter cleaning, sprinkler systems, landscaping, mulch, storms, fire, earthquake, floods, other acts of God or incidents of vandalism. _ Homeowner accepts the responsibility to notify the HOA in writing 60 days prior to removing the Antenna. _ When the Antenna is uninstalled, homeowner accepts the responsibility to remove the Antenna, base, and wiring so that in any event, wiring is capped and penetrations into the exterior building surface is properly repaired and left in a completely waterproof condition. _ Jasmine Heights HOA Satellite Dish Application Revised June 2007 Page 4 of 5

5 REQUEST FOR APPROVAL FOR SATELLITE DISH/ANTENNA INSTALLATION JASMINE HEIGHTS HOMEOWNERS ASSOCIATION, INC. I have read the foregoing application and certify that all the information provided above is accurate. If any of the information above changes, I will submit a new application for review. If the Antenna does not meet the requirements above, I will take remedial steps including, but not limited to, removing the Antenna unit and repairing any damage caused. The remedial work, if any, will be carried out by licensed professionals to the satisfaction of the HOA and at no cost to the HOA. Please Print Name Please Sign Name Date Mailing Address (if different from property address above) Home Phone # Work/Cell Phone # Please return the completed form and Dish/ Antenna installation plan sheet to: Jasmine Heights C/O MB Homeowners Management 700 Gale Drive #140, Campbell, CA Tel: Fax: ********************************************************************************************* Please note that the proposed satellite dish installation must be discussed, reviewed and approved by the Architectural Committee prior to installation. Be sure to provide complete contact information on this page so that an appointment can be set up with the Committee. ********************************************************************************************* FOR HOMEOWNERS ASSOCIATION USE ONLY Date Received: Check One: Approved Approved with contingences Denied Unable to approve - Additional Info needed By: Title: Date: Jasmine Heights HOA Satellite Dish Application Revised June 2007 Page 5 of 5