08020101 (2) CITY OF CUPERTINO
BUILDING DIVISION P�RNIIT COITRAC�"TOIi INFORMATION
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D PERMITNO.
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Y'bfff'CAMINO VISTA DR COBALT POWER SYSTEMS, INC 08020101
ER'S NAME: PERMIT fS5UE GATE
MANISH SINHA & RITU PRASAD 2444 OLD MIDDLEFIELD WAY 02/28/2008
PHONE: 01V V SANITARY NO. CONTROL NO.
(650) 938-9574
ARCHITECTOINGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
;roes LICENSED CONTRACTOR'S DECLARATION lob Description
I u 1 bcmby affirm that 1 am liocroud under provisions or Chapter Y(commencing -
with Section 7001BofDivision Sofdo,Buriness and Norman...Code.and my license I. INSTALL ROOF MOUNTED PHOTOVOLTAIC SOLAR POWER
t=� in full fares and affect. O�[I'J
;✓�Z License Class Lk.N SYS (NO BATTERY BACKUP) —PAINT PANEL FRAMING TO
Coractor1~� Dam ARCHITECTS DECLARATION MATCH ROOF COLOR.
i 1 understand my plans shall he used as public records
iyU
.rj 3 Liueued Professional
m
OWN EmexemOER DECLARATION
<0 I hereby max. +(ionSol that 1 1. .Burin from One Conuacmfs License Law for the
.o O which
moon.(Section Womm Business and ove,a mil Code:AnY city as county
f$ which mguims a permit to commumt.alter,impmm,dcmollvh,or repair any ametum
--Er^ prior us its issuance,also mquims she applicant for such permits.51c a sigocd summent
ci< the,he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.F[.Floor Area Valuation
Vit-$ (commencing with Section 7000)of Division 3 of the Business and Professions Cade)or 31852
Nat he la exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by airy applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy Type
nal marc Nan fivehondted dollars(S500). 3 4 214 0 6 4:'t7 V
C3 1,as owner of the property or my crndayces with wages as them sole compensation, '
will that the Work,and the struma ,is nest intended ar offend for sale(Sm.7044,Busimss Required Inspections
and Pmfesaloes Code:The Contractors License law does not apply to an owner of q p
proper who builds or im proves thereon,and who docs such work himnlf or 0uough his
own employees,provided that such improvements an not intended araffere l for ale.ff. '
however,Ne building orimprevernam is said within aro you of oompletion.cite owner-
builder will hate the burden of moving that he did not build or improve for purpose of
ale.).
0 1,as Owner of the property am exclusively contntling with licensed cmaanoss m
construes the Project(Sec.706/.Business and Profusions Code:)The Contraemfa U
cense law does not apply ad a owner or property who Wilds or improves thereon.and.
who contracts for such projects with a comracor(s)licensed purauam as the Conmanofs
License law.
❑ lam exempt vales See .B k P C far this rOssan
Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Pendry of perjury one of the following dalarasionr.
I ham and will maintain a Cenilic.0 of Consent o selFinaure for WorkcesCmopnm
sation,u MA&d far by Section 3700 of the labor Code,fm the performance of the
work far which on,permit is Wood.
❑I have and will maintain Workefa Compeuation Imuran¢,as tryuired by Section
3700 of the Labs Code.far the perfarmace Of the work far which this permit is i aced. '
My Warkda Compenadon Inwmnce artier and Policy number am:
Cartier. 'LIY1CzLP'1QU-sA0f A4� oliq No;eW Il,00091470
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mos section need not he completed if the permit is fare.woush ddollan($100)
or less.)
1¢nary that in the performance of the work for which this Permit is issued.I shall not
employ anyperan in any m.mmra as m become subject is the Workers'Cotnpeuatian
Lawn of c.lifomis.Data
Applicant
NOTICE TO APPLICANT:If,arm,making Nu Cenifium of Eeemption,you should
become abject in the Worker's Compensation provisions of the latter Cade,you must
,J O forthwith comply with such provisions of Nis permit shall ed drered revemA. '
Z h CONSTRUCTION LENDING AGENCY
(r Ihereby affirm that then is a constmetion lending agency for Ne perfotmamx of
D.' the work for which this permit is issued(Sec.3097,Civ.C.)
W p Lender's Name
z Under's Address
U C) I certify that 1 have read this application aM sum this the sham information Is
ty F comet.l age¢o comply with all city and county ordinances and state laws miming to
O U building construction.and hereby authorimrepresenutives of Nis city to enter upon the
a above-mentioned pmperty fm inspection purposes.
(We)agree to save,Indemnify and keep haodcss the City of Cupertino against
tiLq liabilities.judgments,casts and expenses which may in ay way aeeruc against read City
U aZ in conngoorem of the gaming of this permit,
�-" APPLICANT UNDERSTANDS AND MILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR E ULATIONS. I -
Mt� 12 �25��08 Re-roofs
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Signora fAppliesnUContnctar �—
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will the applicants future building aceupat stun or Na dlc hausual..material
as derined by tie Cupertino Municipal Code.Chapter 9.13,and the Health and War,
de,Section 35532(.)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes off<
Will the applicant or future building occupant use equipment of devicm which If a TOOT is installed without first obtaining an 105peCClODt I agree to remove
emit W.M.us air maumin.mr u Racal by the Bay Arca Air Quality Management all new materials for inspection.
District? /Jh
❑Y.
C '
I have real the hazardous rhamri.H requiremcnu under Chapmr6.95 of the Cable,
nice Health h SafclyCode,Sm6cas 25505,25533 ard255M.1 urdcrstsM du Wds:Wilding .
does not contend,have a omen).Net'to
my tenor.Y m rotitj dm occupant f do
mgaimmenta mmvtbcmetpdo,exiasa afacerdrm.mora army. Signature of Applicant Date
Owner ataut orixedagent ma All roof coverings to be Class"B"or better