11020073 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 817 COTTONWOOD DR CONTRACTOR: FRONTIER SOLAR PERMIT NO: 11020073
INC
OWNER'S NAME: HUIYU FENG 6950 ALMADEN EXPWY PMB 159 DATE ISSUED:02/24/2011
OWNER'S PHONE: 4084219247 SAN JOSE, CA 95120 PHONE,NO:(408)927-9335
❑ LICENSED CONTRACTOR'S DECLARATION (`" r F
BUILDING PERMIT INFO: BLDG FLECr PLUMB
License Class L /O C Lib Lic.# �, Wit✓ L` r— r- r-
p 71-, MECI1 RESIDEN'r1AL COMMERCIAL
Contractor C r�� �1 F I( -�j o +c' ,� Date �'i`Gl�/�
1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOBDESCRIPTION: INSTALL ROOF MOUNTED GRID TIED SOLAR PANEL-16
(commencing with Section 7000)of Division 3 of the Business&Professions PANELS 2.8 KILOWATTS
Code and that my license is in full force and effect
1 hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$19000
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:36917031.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS,OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the f I
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: ! f
with all non-point sourc�rE�Pulations per t Cupertino Municipal Code,Section
9.18. R roofs FS:
Signature - ' ' S� Date � /� All roofs shall be inspected prior to any roofing material being installed. If a roof is
�— installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALI,ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to I IAZARDOUS NIATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Ilcalth&Safety Code,Sections 25505,25533,and 25534. 1 will
1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Elealth&Safety Code,Section 25532(x)should I store or handle hazardous
1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous
Corn pen sat ion,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District 1
performance of the work for which this permit is issued. will maintain compliance with the Cupertino-Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Elealth&Safety Code,Sections 25505,25533,and .534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agen� Date:
04
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate ofexemption,1 CON'STRUCT'ION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of'
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments. ARCHITECT'S DECLARATION
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date