09120083 Y OF CUPERTINO BUILDING PERMIT
CIT PERMIT NO:09120083
CANYON RD CONTRACTOR:SUNGATE ENERGY
BUILDING ADDRESS: 10708 STEVENS SOLUTIONS
6335 FERRIS SQ STE B DATE ISSUED:01/21/2010
OWNER'S NAME: BAJARIG&HUANG PHONE NO:(858)457-4500
SAN DIEGO,CA 92121
iER'S PHONE: 4085981598
BLDG ELECT PLUMB
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO.•
(' COMMERCIAL
License Class Lic.#
7 w)4 C) MECH RESIDENTIAL
Contractor JUN 0/� Date JpB DESCRIPTION:INSTALL 1.5 KW PV SYSTEM
I hereby affirm that I am licensed under the provisions
the Business pte Professions
(commencing with Section 7000)of Division 3
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-Labor Code,for theEn*.Y$28Y00
Compensation,as provided for by Section 3700 of the nsure for Worker's Valu
rAAPN
Ft Floor Area:
performance of the work for which this permit is issued. as provided for by
I have and will maintain Worker's Compensationdence of the�work for which this Occe:
Section 3700 of the Labor Code,for p Number:35603058.00
permit is issued.
APPLICANT CERTIFICATION
that I have read this application and state that the above ins a�,a`°S relating T EXPis IRES IF WORK IS NOT STARTED
I certify 1 with all city and county ordinances and pv
correct.I agree to comply authorize representatives of this city to enter IN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby purposes. (We)agree to save WITH
above mentioned property for inspection purp ies judgments, DAYS FROM LAST CALLED INSPECTION.
upon the 180 DA
indemnify and keep harmless the City of Cupertino against liabilities,J g
ity in consequence of the
costs,and expenses which may accrue against said understands and w ll comply Date: /�l X
of this permit. Additionally,the applicant '��c�--'��
granting p Issued
with all non- oint source regul ions per the Cupertino Municipal Code,Section
9.18.
Date d
Signatur RE-ROOFS:
roofing material being installed.If a roof is
All roofs shall be inspected prior to any g ree to remove all new materials for
OWNER-BUILDER DECLARATION installed without first obtaining an inspection, ag
� inspection.
I herebyaffirm that I am exempt from the Contractor's License Law for one of Date:
the following two reasons: Signature of Applicant:
I as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure isnot intended or offered for sale(Sec.7044, ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code).
HAZARDOUSMATERIALS DISCLOSURE
irm under penalty of perjury one of the following three 25533 and 25534. I will maintain
I have read the hazardous materials requirements under Chapter 6.95 oft e
I hereby aff afety Code,Sections 25505,
declarations: Chapter 9.12 and the Health&
I have and will m
aintain a Certificate of Consent to self-insure for Worker's compliancef ��vith the Cupertino Municipal Code,handle hazardous material.
provided for by Section 3700 of the Labor Code,for theshould I store or
Compensation,asp Safety Code,Section 25532(a)
which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air
performance of the work forCompensation Insurance,as provided for by Area Air Quality Management District I will
contaminants as defined by the Bay
I have and will maintain Worker's Chapter 9.12 and the
maintain compliance with the Cupertino 5505,25533,and 25534e�
Section 3700 of the Labor Code,for the performance of the work for which this Health&Safety Code,Section
permit is issued. issued,
I certifythat in the performance of the work for which this permit i e c'shall Own r a orized gent:
not employ any person in any
manner so as to become subject to the Date:
Compensation laws of California. If,after making this certificate of exemption, ust
become subject to the Worker's Compensation provisions of the Labor Code, �.� CONSTRUCTION LENDING AGENCY
d revoked
forthwith comply with such provisions or this permit shall be deeme . ce of work's
I hereby affirm that there is a construction lending agency for the performany
APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.)
I have read this application and state that the above information
relating Lender's Name
I certify that ordinances and state
correct.I agree to comply with all city and countyto
construction,and hereby authorize representatives of this city o save Lender's Address
to building co for inspection purposes.(We)agree
upon the above mentioned property P ARCHITECT'S DECLARATION
harmless the City of Cupertino against liabilities,judgments,
unify and keepCity public records.
and expenses which may accrue against said understands and will of
I understand my plans shall be used as p
granting of this permit.Additionally,the pplecant
with all non-point source regulations per e Cupertino Municipal Code,Section Licensed Professional
9.18.
Date
Signature