08070092 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTORIN.PURMATIaN -
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BUILDING ADDRESS: PERMIT N0.
2.2294 CARTA BLANCA ST SOLARCITY 08070092
NER'S NAME: PERMIT ISSUE DATE
Al,BERT SEDIGLYDOUR 393 VINTAGE PARK DR STE 140 07/23/2008
ONE: SANITARY NO. CONTROL NO.
(650) 638-1028
ARCHmiCl/ENGINEER: BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
"AtLICENSED CONTRACTOR'S DECLARATION O O O O
a 1 hereby affirm that 1 am limned under provisions of Chapter 9(commencing Job Description
i
with section 70("ofDiAston3ofNeBusnevAnal RolessbmCode.And myliccnait ADD 2 . 46KW RF FLUSH MNT PHOTOVOLTAIC SYSTEM
< in 17.11 force Ana effect
I3canmclm Lle.r
Dam Contractor
ARCHITECTS DECIMATION
22 1 under and my plans"I W Wool At public rtcoNs
JyU
g o Liconmd Professional
NOWNER-BUILDER DECLARATION
1 hereby arcrm Not I em exempt from Ne Conoattoes License Law for the
C 0 O following moon.(Section 703 1.5,Bulmxs and Profeaioa Code:Any city or county
$ which mquires a permit to eonvuck alcor,Winnow,&AmIt%h,or mpvir any rectum
prim u its issuance.also requires We applicant forsuch Permit to file a signed suciceent
pyo
that hehlicemdpurmuntmtedprovision ofNeContsubsSliaveLaw(Chapter9 Sq.Ft. Floor AreaValuation
u WAMAnttcingwith Section 7000)ofDivision 3OfWeButionuandProfcaiouCode)m $11000
s Nat he u exempt tbomfrmm Anal the buss In,the alleged eaanplim Ally violation of
Seetlon 7031.5 by airy applicant for a permit subjects the applicant N a civil ponally of Number
Occu ane—Type
Amt more Nan five hundred dollars($500). 32613045 ,
lumP Y
01.uownsoftheproperty,mmYwploymwithwagsut irmlee°mpemdon,
will do the work and the twerum U not immnded oronered forsale(Sec.704<,Bumnext
And Pmfesdou Cala:The C.,mmmr's Litre law dons Act apply m an ower of Required Inspections
property who WBdturimpmw Nacon.and who deeoamh wmithimsalfortnmeth his
own employees provided that such impmaemenu Ane not inmMrd aoBemd ferule B,
1mwevv,We building or improvement umld within ore)ear of wmpletion,the ower.
Wilda win have the Wrden of proving that he did not Will m improv fa purycm a
sale.),
0 1.u owner of the property.Am aaluaivaly contracting with licensed common N
coam7.er the project(Sec.7044.Bualnas and Prefesflmm Code:)The Cmmixwes U.
core Law does not apply m an owns of property who W ills 7.r improves freon.Aril
who contracts for such projects with a eommoker(s)lioemd purmant in tiro Contncto.
Llccm Law.
0 I om exempt under See ,B d P C for Nu moon
e Date
WORKER'S COMPENSATION DECLARATION
1 bereby N'om under penalty of perjury,ore ache following deelmaimse
❑I lure vM will maintain•Cutifiam of Cotuent m telt-iuum for W°rtcYSCompen- -
sation,An provided for by Section 37M of the Labor Code,for the perform.of the
work for which this permit is Waited.
I have and will maintain Workers Compemti°n Luurancc.u required by Section
37 oftim LaWr Code,fm the performmca mfthe work for which Nis Permit In ivuad. '
My Werke.Compemtion forion nco carer aM Policy number Ane:
Garrice S Policy No.:CI�O V /V 4 IC)
1 ATE OF KEMPTION FROM WORKERS
COMPENSATION INSURANCE
)( his section need rot be complemd lithe permit d forma,hundred doors(5100)
Ar con.)
1 certify that in We performance of am work for which this Permit is issued.I shall not
employ any person in my murerm At m become subject in No WmkerYCompemtion
Laws Of Califomis Dam
Applicant
NOTICE TO APPLICANT:IL ane,making this Ccrficam of P.nihn.you b.id
become subjen m Na Worte/A Compemti°n providAre,a the labor Code,you must
C)O forthwith comply with such provitloa m Nu permit shall he demmcd rewtee. -
Z rjl cONSTILUCnON LENDING AGENCY
[—r I hereby affirm deal Nem is A coatroctim lending agency for N°performance of
(x r7 the with for which Ott pemtit 4(sued(Sec.3097,Civ.C.)
W� p Lenders Name
Z Landers Addrm ,
U Q 1 Ot nify that I have road this application and time Na We AW,e indorma im d
U.U correct 1 agrees m comply with All City and county mdinarw AM state laws mlaong N
DWilding construction.aM hereby mNore mpreoauties of Nu city an enter Open tie
Fabove-mcouon d propcny for nepeeim pugnes a (W,)agree to save,indemnify and keep harmless the City of Cupertino Against
fI) ILabilitim,judgmenB,costa And expems which may in my way amu,agamaiLsaid City
U,'Z A APPLICANT
of Negranting of Nh permit. J�
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:. Date —2
SOUp��RE�G�ULA770N5.
1 �I 1 jb_ 2 Z14 ) 7 QDIP V Re-roofs
Srgwum of
HAZARDOUS
AZAR ApphcaOU
xnz rhomme MATERIALS DlsaosuRE Type of Roof
Wipe NeeCucantmfuturesipal CaamryantraemAnd, hcAb material
At dcfimy DY the Cupertino Municipal I Codc.Chapter 9.1;aM Ue Health And S+Iety
section,2553z(a)7 All roofs shall be inspected prior to any roofing material beim
❑Ya �("° g installed.
Will the applicant or future Wilding occupant m equipment At dcvkca which If a roof is installed without first obtaining an inspection,I agree to remove
District?almnud u
s air cominandc0tmd by the Bay Area Air Quality Management all new materials for inspection.
❑Yca kNo
I here mad We hauNau mamriall roquWmc as umkr Clupmrti.95 of tiro Califon
nu Health&SAfetyCmh,Sxvw25505.25533 aM 25534.1 underrated thea ifthe holding
does mot cmmMy bac•moanL that It is my m,peruibility m rectify the occupant of the
main ire whirhmtutbeme rtuissuvuemftcemlacaactfif upancy. Signature of Applicant Date
�'7( nn� D laaI(X
Owner or moorvmd agent Dim All roof coverings to be Class ;IV'or better