03070162 (2) CITY OF CUPERTINO
x BUILDINS DIVISION PERMIT ?CONTRACTOR INFORMATION
BUILDING ADDRESS: MC SOLAR ENGINEERING PERMIT ND03070162
An VATT
tOWNERSNAME' : 1168 ASTER AVEPERMRLSSUEDATE
NE: SANITARY O. CONTROLNO.(408) 261-1211HITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMBMECH0 0LICENSEDCOcensed r, rnor EGLARATION
1 nemny.ftirm Lha,I,m naasca un pmvisinm nr cnapmr 9(rnmmenrmg Job Description
is ctio al1(NI)nfDiA.ion3of NC Bu rad Professions Cndc,andmylimmaris
ll d;ffect-�yG Lic.P a-( 16S INSTALL 2KW PHOTOVOLTAIC S ®P A6E®na ago cram, ,
SS ARCHITECTS RATION
K i I undersund my plans shall be useJ s public mentis
SEP 0 5 2003
in
Lkased Profess Oran
`0S OWNER-BUILDER DECLARATION
. <q 1 hereby affirm that 1 am exempt from be Convector's License Law for the rjean n'WP r�'M ��
0llowing reason.(Section 703 1.5,Business and Professions Code Any city or county YKV■0 Billowing
requires a permit to construct,alter,improve,demolish,or¢pair any structure
prior tells issuance,also mquira the applicant for such permit In file a signed sutemcm
E
�< that he is limmOd pumuavuru the provisions of the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area Valu tion
tic (commencing wi It Section 7IX0)of Division 3 of the Business and Professions CMe)or
our,$ Nn he is exempt shallow and tic basis for Or alleged exemption.Any violation of
Section 7031.5 by a"Applicant fora permit subject,the applicant to a Civil penalty or - APN Number Occu ane-Type
not more man finnundmd dollars($500).
P Y ,
0 h u come,of the pmpeny,or in,cmploycu with wages as their sole compensation,
will do the work.and the structure is not intended or offered for so).(See7W Bodiless 101 - FOUNDA Qp� Inspections
and Pms'am feCode:The Convecmcs r's License law donot apply to an owner of
pmrcny who build..,lotions Neuron,And who Once such work himselfor,Brough his 102 - PIERS
own employees,provided that such improvements an not intended or offered for sale.If. 103 - UFER
however,the building or improvement is sold within nor year tire Of completion, e owner.
builder will nave do,burden of proving that he did not wild or improve for Porpoise of 104 — REBAR
sale.).
0 1,AS owner of Be prorcny,am exclusively convening with licensed contractors to 105 — ANCHOR BOLTS
coax incl the project sm.1844,Business and Professions Code:)The Conbamr's Li. 106 — SEWER 6e WATER
arse law does not apply to an owner of property who wilds or improws mere.n,and 202 — UNDERFLOOR PLUMBING
who c^ntneu for such projects with a eonlnemr(s)licensed pursuant o the Contractor's
LicenseIAA Law. 203 — UNDERFLOOR MECHANICAL
El aempt Doerr sec. .B&P c rid mice mason
ate 204 — UNDERFLOOR FRAME
Owner WORKER'S COMPENSATION DECLARATION 205 - UNDERFLOOR INSULATION
I hereby affirm under penalty of perjury one of the following declarations: 301 - ROUGH PLUMBING
Ihaze and will maintain a Cemficam of Consent to see-insum for WorkersCompcn- 302 — TUB & OR SHOWER
s,as provided for by Section nue or the law,Crude,for the pertO mina of he 303 — ROUGH MECHANICAL
work for which this permit is issued.
0 I have and will maintain Worker's Compensation Insurance,As inquired by Section 3 04 — ROUGH ELECTRICAL
nW.f the Law,Code.for Or perfmmana of Use work for whim Iia .it is issued. 3 0 5 - FRAME
My Workers Compensation insurance anie/r ayne Pp hey number are: 305 — FRAMEHOLDONS
C\ S?4 Fry iA xpylfeyNo: /SNOOSR—aa
C\
CER FICAEOEKEMPnONMOMWORKERS' 307 - INSULATION
COMPENSATION INSURANCE 308 — SHEETROCK
orlessj3^s.rreion need not we.mplemd iftnc prrmB is foal nundmd dollars I$HXB 309 — EXTERIOR LATH
I anify mat in the performance of the work for which unix pmmi,is issued,10111 not 310 — INTERIOR LATH
employ any Person in any manner so as it Become subject mhe Workeri Compensation 311 — SCRATCH COAT
Laws of C,lif.....Date
Appliam 313 — ROOF NAIL
NOTICE TO APPLICANT:IL after making this CeMR1111 of Exemption,you should 501 FINAL ELECTRICAL ENERGY
become subject m the Worker's Compensation provisions of the labor CMB you must
D� mrthwimamplywith a rap,ruviainnsrurtmarcrmitsnalweremedm ,trd. 502 — FINAL PLUMBING ENERGY
z ^ CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY
F^ k(mwyaf8ridthnlncmissed(Sm.309 , encylnrmeperfmmanccnf 504 — FINAL BUILDING ENERGY
a� the work fur which this permit is issued(Sec 3(M11,Co.Civ C.)
i p LendcrsName 505 — FINAL ELECTRICAL
= z Lemurs Address 506 — GAS TEST
U 0 1 cenify mu 1 haw rad this application and sure that the even information is
LL F collect 1 agree In comply with all city and county ordinances and sum laws miming to 507 - FINAL PLUMBING '
O V buildingcouswetion,and nemhyamnoriaemprmrnL2IivesofBig City toenter upon are FI&aNWG(CAL
ehovementioned property for impaction purposes.
H y (we)agree m save,indemnify and tap ha msess the City of Cupertino against 0 C3 FI
h liabilities,judgments,costs and expenses which may in any way acemeAgainst mid City 5 Z in eonsequcrim of me gaming of this permit.APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 DaleSOURCCE,E,gEGU IONS. RKS
pV!�
Signnurc Ap1(f2UConvactor Dai O� Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
will the applicant or future building occupant store or handle haamdous manual
m defined by the Cuyenlno yf,rn;clrel Code.Chapter 9.12.and thc Health and Safe,,
c.de.Section tics zss3z(a)+ All roofs shall be inspected prior to any roofing material being installed.
❑ Nu
Will the applicant or future Wilding=upon(use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
Tier? a, lir
❑Yes '✓k}`y,
1 have read Be wraNnusmamrialson uimmass under Chxpmr6.95 of the Califor
nia Health&Safcty Codc.Secuons255115.23533 ad 25534.1 undenund met ifun,building
docs not cuncmly Bowe moan,mut n r y imports,. ity m no.
IM occupant of me
requiremen¢whi mon ba mm prior ance of a Ceni me, cup �k
�` � �- t-af Signature of Applicant Date
0 mianar cdag Dare All roof coverings to be Class "B"or better
CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
PN # 2 �� Date:
✓ xalw
Building Ad ess: Mailing Address (if different from building address):
Coy.✓�'
Owner's Name: Phone#:
307N --� 51- L- 04�6 SSS -�5 ,4
Contractor: License#:
M Iv.r 3a 1 v s
Contact: Phone: (joy a! tv Cupertino Business License#:
o �rre� Fax: � �
ilding Peit Info:
Bld Elect Plumb ❑ Mech ❑
Jobb rlptlOn: 1r S}c �,.._, rj�a�av0��'fnC, S`•1S�A'�" °`^
Residential f r a a Commercial ❑
Sq.Ft. Floor Area: $/S .Ft.:
Cost of Project: 10, O D D OcccuupaancyU oup:
Type of Construction: Please check this box oject is a
second-story addition: ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1 M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V > IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
Iof3 0 / J �,
(CL- CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BOVERTEVIE Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Repipe Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen TrapPLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Kern Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
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sm-5 CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Insection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Tem or Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
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