08070095 CITY OF CUPERTINO
BUILDING DIVISION PERMIT xC,ONTRAC ojR,TyI'O , TION
BUILDING ADDRESS: PERMIT NO.
20894 JOLLYMAN LN SOLARCITY 08070095
NEWS NAME: PERMIT ISSUE DATE
])AN'KEL LEE 393 VINTAGE PARK DR STE 140 07/23/2008
PHONE: SANITARY NO, CONTROL NO.
(650) 638-1028
ARCHDECTIE14GINEEK: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�Op
LICENSED CONTRACTORSDECLARATIONof CON
� 1 Imeby muco,that 1 am teamed under Provisions of Chapter 9(commeming Job Description
win Section 700N)ol'Divlsion 3 oflhc financed and Professions Coic,and my lieena h 4 . 51KW RF FLUSHMNT PHOTOVOLTAIC SYSTEM
^ n con rma anti urea
,g: Lnenre l , Ln.•
canrecmr
ARCHTIECrS DECLARATION
W1 motherhood my plata shall he hand u Public recur at
g Licenced Rofessiansl
R7 5 OWNER-BUILDER DECLARATION
1 I beroby aRrm flat I em exempt from the CanoutK,licence LAW for one
00 following much.(Section 71131.5,Business and Profession,Code:Any city of county
$fLi which re,eirev m permit to cnnauuct.alma improve,demolish,or repair my souctum
prior in in)stuancc.4.mquites theappliant for such permit m ftn a signed atamocm
££S
chat MNhanded pursuantmthe PmvNion,ofthan Conmlm'sLicence Law(C'Mpto9 Sq.Ft. Floor Area Valuation
y+F� (commencing with Section 7000)of Division J of the Business and Professions Cude)or $21000
f 5— that he it exempt therefrom and the bait for the elkged exemption Any violation of
Section 7071.5 by any apidiesm for a Permit subjects the applicant m a civil penalty of
nm down,done five lonaed dollars(S"14 35925054 .Number Occupancy Type
01,uownerofO property,mmy=playedwithngautheremineampensadon,
will dothe wart,and the stmcom is not Intended reofferedfe San(Sec.70N,Besmear
and Pmfe dam c
Cade:The ConomY,Liaa o::law does mat appy to an owner ar Required Inspections
property who Wil&re improves tMjeon,and who does such work himself or through his
ownemployem,provided do, himpro,co mu are am mantled or uRued for Sale.If.
however,the Wilding or improvement Is mW within arc Year of completion,the owocr-
Wilder NO haw the burden of proving that he did not build in improve far Puryam of
ale.).
❑1,u owmr of the Proton,are exclusively contracting with Banned contractors m
comtmct the project(Sec.70x4,Buinesa and Profession,Code:)The Comonemr's U.
cense law does act apply in an owner of property who Wilds or improves thereon,and,
who comoeeta for such Perinea with aconttsnor(s)licensed Pace--m in the Contractors
License law.
0 me amok under See .B At P C for this reams
he
Data
WORKERS COMPENSATION DECLARATION
1 hereby afford under pro ty of perjury one of as following declarations:
0 I have and will maintain•Certificate a Cement to self-insure frewaMrsCompeer-
station,as provided for by Section 3700 of the labor Cade,for the Wrformmence of the
went for which this Permit N isshnl
1 have and will marine.Workers Cmpnsatian Insurance,as mq.ired by section
of the LaWr Coda,for the perionnanc of the wart for which this remelt is issued.
My Wavers commoaad.P..carie and Policynu.m-sber are:
Cartier. Polity No.'�q<T�70u/a) /
C iFTCATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
0 hN xctlan ted not becmpnnd If the Month 4 fora a hundtMdoOm(1100)
or kat)
1 comity pmt in the psfmon.of the work for which thi.Permit u Wood.l"I no
employ any person in my maotarm u in become subject to the Wonm]'Compen,ation
Laws of Califomi&Dan
Applicant
NOTICE TO APPLICANT:IL after making thin Certificate of Exemption.you Mould
become subject m the Workers Cmpn,adon provisions of the Mbar Cade,yon mm
.,O fmthwith amply with such p^vidns re obis Pit shall he dam ted mtrA
e
ZN CONSfRUCT1oN LENDING AGENCY
F I hereby anion that Neto atacomilratiarl Imeinjagency for the performanx^f
a> the won In,which this Permit N inued(sec.309'f.Civ.C.)
W L] Lendce,Nana
7 z Landers Adana,
U Q 1 certify that 1 haw read this application and sun that the move INomudon u
(L cartecl 1'gone or comply with all dry and county, and sum have opting in
O Wilding cormmnion,and hereby mlAodre mpmumohm or that city to emer upnn thef\--tt/.../,./ /
shove-mentionedpropny for inspctim whichPUrPML
F y (We)agree W Saw.indemnify and keep harmless the City of Cupmirw mgaiast
y in
aunce of thecoetsmdofpmemeek. may In any Way acme agsinst aid City
U Z m consequence of NC RSTAN of IAN D WILL
ti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 7 - 2.,4—
sOUgg��E REGULATIONS. a
1AUR A C -p' Jh Zl�3 7Ja`� Re-roofs
Signature of ARlian✓Conoacmr T an
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appliont re future Wilding o:capultstm or handle haarcom emmfal
u defined by as Cupertino Municipal Code,chapter 9.13,and as Health and Safety
.Section 2S5J2(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yee �No
vrn the a Fant of rhtrec Wilder
."int. If a roof is installed without first obtainingan inspection,I agree to remove
emit huudnm air rnnumirunu u defmE b ft Ba Am A�Gualit Management
Di,hinL7 r r rall new materials for inspection.
❑Yen AN.
I have mad the henMImis maherwir quimmcw under Ompmrb.95aftheCslirm-
nNHeaW&Safety Code.Seem=25505.25533mnd 25.534.1 amendment thatifte,Wilding
dw cot cuncntiy have a tome thaL it N my mpomibility in notify the occupant or the
requla nuDwhnhZ met nivumceofa faanafOccupmcSignature of Applicant
nt Date
Owner of mthmri hC1sd agcm
n P a All roof coverings to be Class'n'or better
ripan' '