08060108CITY OF CUPERTINO
T.k,CONTRAGTOR INFOIiMAION
BUILDING DIVISION PERMIT
§,:k
BUILDING,ADORTAI AVE
�1NAiMUE: V
SOLARCITY
PERMIT NO.
08060108
HERS
PERMIT ISSUE DATE
VIVEK SALGAR
393 VINTAGE PARK DR STE 140
06/24/2008
PHONE:
SANITARY NO. CONTROL NO.
(650) 638-1028
ARCN3TECT/ENGINEEA:
BUILDING PERMRINFO
BLDG ELECT PLUMB MECH
0 Q 0 0
LICENSED CONTRACTOR'S DECLARATION
lb Description
o
Chapter 9 (commencing
I hereby arfim Jul 1 sm Ilrenxd under provisions of Ch
with Scedon]IXIU)ofDivi.Jon S of tie Bores, and Prafessimc, Code, and my lieam is
ADD 4.1KW RF FLSH MNT PHOTOVOHAIC SYS
in full farce and L
lff
License Class Le.0 Ci'Y
Dab O
DE
TS DECLARATION
ARCHITECTS
I untictmanJ my plain shall W used as publiL rtcorg
Licensed PmfeaJaoai
OWNER-BUILDER DECLARATION
1 hatch, ,lTm Nat 1 am ueropt from me Ctenbacte/s Lice t- Law far the
following reason. (Section 7031.5, Business and Pmkssums Cade: Any city ar county
which requires a permit to cOnswcl after. improve. demaluh, m repair any feature
! prior b its issuance. also requires me applicant ferment permit to rile a signed statement
to the of tie Conmebre Lianse Law (Chapter 9
Sq. Ft. Floor Area
Valuation
that he is licensed purmant previsiam
(commencing with section 7000) of Division 3 of um Burins and professions Co le) or
$21000
that as u ucmpt memfmm and the thou for the alkgcd caempdon Any violation of
36205022.E Number
Occupancy e
ane T
P Y YP
Section 7031.5 by any applicant for a permit subjects the applicant b a civil penalty of
nm come Nan five hundred daluca($5130).
I, u serer of Jk property, w my employees with mgu u theirmle ctempemdon,
Mli do the work. and she saurian u.1 handed orteRered mrmla(Sce.](I14, Bminm
Required Inspections
and Professions de: CaThe commences Litten Law des not apply to an owner of
Property elm build, wimproves rhereon,and wW doeasuch work hinnselforNmugh his
we employees. provided that such improvements are not intended oro@rid for We. If.
however, Imre Wilding or improvement is mid within and year of completion, me owner-
Wilder will have the burden of proving that ha did Out Wild or improve for purpose of
cak.).
❑ 1. as owner of the property, am enclosivsly comwormg wim licensed conuxmn In
construct the project (Sec. ]DW. Business and Profelilam Code) The Cwb,ebf 3 LI-
cam law do not apply to in owner of property who Wilds or improves thereon, and
who conuaua for such projects with a conuaebgs) licensed puraum in this Consnctors
—
License Law.
'
❑ Iart.m.ptumer See .B&PCfuthismase:
nu Data
WORKER'S COMPENSATION DECLARATION
1 hereby strum under peaty of perjury tem of the following decure0ons:
❑ I here and will bi fi7M of Comnt b calf-icor Wands Ctempa-
Smacm
provided for SsNen 3]Oo of me labor Code. for me performance of the
write:, uprofor the
h mi
wort for which this Permit is issmg
1 have and will maimam Workers Compensation 1 swanec, a taunted by Scanlan
]Oo of the Labor Code, for the performs .. of the work for which this .it is issued.
'
My Wmkaes Campcmti n Insonna unite and Polley number am:
"
Carrier. Policy No.�Gi�%l7ti l a%
RTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thusecom need not 4 completed time Permit is foram bunged doll ($1013)
m kat)
I unify chat In the Performance of than work for which this permit is issued. l shall not
employ any pcsson in my answer an as to become mbject to pe Womers Comp mertim
Laws of Califomis. Dare
Applicant
NOTICE TO APPLICANT: If. after matting this Cenilicam of Exemption, you should
become subject in Wa Worker's Compensation provisions of me IaWr Cede, you must
formwide comply with such provisiam or mu Permit shall ba decreed corked.
CONSTRUCTION LENDING AGENCY
1 hereby "m mu inert is a counteraction lending agewy ror the perfumance of
the wish for which this Permit u issued (See. 3097, Civ. CJ
Lender's Name
'
fender's Address
I anify that I have read this application and sum that the above in(omutim u
cartel. I agree b comply with all city and county ordlnaLLee and stale laws missing to
bending crosenim, and hereby mthoriae representatives of this city in aur upon the
stave-mentioned Property for impaction purposes.
(We) agree to cave, indemnify and kap hamlet the City Of Cupertino Against
liabilities, jWgmcnu, coat and eapemea which may in any way scone against said City
-
incomcguenceofthe Starting ofthis Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by: Date
SOURCE REGULATIONS.
Re-roofs
� � Ia72 l %O n n /0
7
Sig:amof Applfan✓ manor / D
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will Use applicant or future Wilding occupant time or handle hanrdouv material
as darimd by the Cupertino Municipal Cade, Chapter 9.13, and the, Health and Safety
er.C]YYu 3(7asaonzss3z(,)]
All roofs shall be inspected prior to any roofing material being installed.
Will IW applicant or future Wilding oavpantmequipment ordevices which
If a roof is installed without first obtaining an inspection, I agree to remove
emit hsvaromo air communities as defined by Ole Bay Area Air Quality Metal; ... I
all new materials for inspection.
District?
❑Yes,jgte
than mel the huardoesn dais q imnanuungrClupw6.95oftheCalifor-
niaHcaim&Safely Cade Seed.35505,25533 am1355M. I,mdemund thatifdme building
de•.a mt currently have a mumu that it is my respansihility in notify the occupant of One
requii�m,nmmcnu which most W me"orb issuance efa Cam amaroan a,/
Q
Signature of Applicant Date
6°L Y? 'i jopjl
All roof coverings to be Class 'W' or better
Owneronutharvcd, em — T— teaomw