13050080 :CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR-TBPPERMIT NO: 13050080
OWNER'S NAME: VILLA SERRA APTS, G DATE ISSUED:05/09/2013
OWNER'S PHONE: 6509313400 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ElCOMMERCIALE]
License Class l� (Q Lia# O 1�-�3 INSTALL EV CHARGING STATION
Contractor `rera+'t /C� r Date`
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3of the Business&Professions
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-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:$3000
I 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 APN Number:32609073.20800 Occupancy Type:
permit is issued.
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 DAY R LAST CALLED INS E I TION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply Issued by: Da
with all non-point source regulations per the. rtino Municipal Code,Section
9.18.
RE-ROOFS:
Signature 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.
❑ O ER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that.1 am exempt from the Contractor's License Law for one of
the following two reasons: ALL 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)
I;as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Co Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 5505,25533,and 4.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Dater
permit is issued.
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,aftermaking this certificate of exemption,I Ci�NSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
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
ALTERNATIVE ENERGY PERMIT APPLICATION �0
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION Vb
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228• FAX(408)777-3333•building0cupertino.ora \�
PROJECT ADDRESS2C�%O O APN# 3�`
OWNER NAM L e (JJ � a P ON I Cj'-- E-MAIL
STREET ADDRESS CITY, STATE,ZIP FAX
CONTACT NAMEPHONE E-MAIL
y►' L 707—a87—�f93$' Carr,_ elPc rc �o �vr�•-�
STREET ADD ESS vn _J� CITY,�T�ITE. IP Qom/
❑
OWNER ❑ OWNER-BUILDER' ❑ OWNER AGENT CONTRACTOR J1:1 CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER r ❑ TENANT
CONTRACTOR NAMe"*17 VV LICE��� 3 B T LICEFi BUS.LIC#
Zoe
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COM NY NAME E-MAILFAX
1#O, co 707-26 . p 2
ET ADDRESS. r_q,q1O C ,STATE,ZIP �j-� PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER �(> BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex Multi-Family PROJECT IN WILDLANDPROJECT IN
STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes YNO FLOOD ZONE ❑ Yes X--No
❑ SOLAR PANELS ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER:
FOR SOLAR PANELS.• NUMBER OF PANELS/UNITS: #KILOWATTS: TOTAL VALUATION
DESCRIPTION OF WORK�h // e ec el c ve //cAo C4
-sO11)
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have rea Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b g construction. I a e resentatives of Cupertino to enter the above-iden/tified property for inspection purposes.
Signature of Applicant/Agent: Date:
,OPPLEME>WWL INFORMATION REQUIRED OFFICE USE ONLY
W OVER-THE-COUNTER
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LARGE
MAJOR
PVApp_2012.doc revised 06/20/12
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
.' ADDRESS: 20800 HOMESTEA RD DATE: 05/09/2013 REVIEWED BY: MENDEZ
APN: BP#: *VALUATION: $3,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION SOLAR-COMM
USE: Commercial Building PERMIT TYPE: i
woKK INSTALL EV CHARGING STATION
SCOPE
v .
x��a.<,. �� t�� � ', ���$'`r '�#� �.�.� �`� _ ��..eau r � •���__�.
tech. Plan Check Phonb.Plan Cheek Elec.Plan(,heck
bfech.Permit Fee: Plumb.Permit Fee: Elec. Permit Pee:
Other,Wech.Insp. ED_L__ Other Plumb Insp. Li L_ Other Elec,Insp.
Li
Hech,Insp.Fc e: Plumb. Insp.Fee: I Elee.Insp.Pee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,Sehool
District,eta). .These fees are based on the prefinWha information available and are onl an estimate. Contact the De t or addn'l info,
FEE ITEMS (Fee Resolution 11-053 E . 7ff 11/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 0 # Alternative Energy System
Suppl.PC Fee: (E) Reg. ® OT 0.0 hrs $0.00 $102.00 ICHRGSTA EV Charging Station
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-.(E) Reg. OOT 0.0 hrs $0.00
PME Unit Fee; $0.00
PME Permit Fee: $0.00
Constfztction Tax:
Administrative.Fee:
Work Without Permit? ®Yes: No $0.00
Advanced Planning Feer $0.00 Select a Non-Residential 0
Building or Structure
Travel Documentation Fees: �
Strong Motion Fee: IBSEISMICO $0.63 Select an Administrative Item
B1djZ Std s Commission Fee: IBCBSC $1.00
RIM
$1.63 $102.00 $103.63
Revised: 04/29/2013
I''LQT PLANS COPY
CMC"UD BY PAGE 1 OF 2
DA ✓ ✓r'L
( )Char1 a oint CT2023
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(See Attached Mounting Detail)
PLANNING IDEPT.
DATE The Markham
Apartments
13i.1[)G. DEPT.
Access Ramp 20800 homestead rd.
Cupertino CA 95014
(408)257-1060
ABMW
BO &"gftu
E.V.Charging E.V.Charging
Parking Only Parking Only
with E.V.Charging 2142 Rheem Drive
Access Pleasanton:0AT94588
Cdlfj 1tl, 98-8312
91 > 5 !x(925)126-0225
russellbe
f` - C l0�tse�hce"96`�6,�
to r�aK, any
or o
Building DepartmentOT
hO `'edvc h cp-P ex&I1 fh
MAY 0 9 2013or
l)o r'e S fr�/h� 1 va. W.
REVIEWED FOR CODE COMPLIANCE
Reviewed By:
Side Detail
Charger Handle PAGE 2 Of 2
Chint
T2023
C /
R023 f/
55.5"
42"
The Markham
Apartments
20800 homestead rd.
Cupertino CA 95014
(408)257-1060
i
I
I 1S"x6"14eal ;
36" Overhead Detail
—�. 14.9 in
A13MM
i Cementtooting I 377.3 mm p,dblls�ll0
8.7 in
220.7 mm 2142 Rheem Drive
Pleasanton CA 945BS
Q
Cell 1925)998-8312
p�, or{ 303jin
Fax(925)426 0225
U Russell,lones0abm.com
0�4 �
Contractors State License:967676 C10
CooE Coop
E0 Lid
- Created by Russell Jones
wed 81. �9d
C 19
ChargePoint®Charging Stations
Specifications
C o L us
usreo
Electrical input
Input Power 7.2 kW(x 2)
Input Voltage 208/240 VAC
Input Current 30 A(x 2)
Input Power Connections Two independent 40 A branch circuits,each providing Line 1 and Line 2.A single protective Earth conductor.
Required Service Panel Breaker 40A double pole breaker(non-GFCI type)on each dedicated circuit
Service Panel GFCI Do not provide external GFCI as it may conflict with internal GFCI(CCID)
Standby Power 7 W typical
Electrical Output
Output Charging Power 7.2 kW(x2)
Output Voltage 208/240 VAC
Output Current 30 A(x 2)
Output Charging Connector SAE J17721m EV connector on 18'(5.48 m)cord(x 2) �G
Functional Interfaces 0
2 � O�
Card Reader ISO 15693,14443 p7
Ground Fault Detection 20 MA CCID with auto retry(15 minute delay,3 retries) 6> ® Q
Plug-Out Detection Power terminated per SAEJ1772Tm specification
Power Measurement 2%015 minute intervals �y
Local Area Network 2.4 GHz 802.15.4 dynamic network y.
Wide Area Network Commercial GPRS or CDMA cellular data network
Safety and Operational RatingsLF .,
Safety Compliance UL listed for USA and cUL certified for Canada;Complies with UL 2594,UL 22311,
UL 991,and NEC Article 625
Surge Protection 6 kV 0 3000 A.In geographic areas subject to frequent thunder storms,supplemental sur ection at
the service panel is recommended.
EMC Compliance FCC Part15 Class A
Operating Temperature -22°Fto122°F(-30°C to+50.C)
Operating Humidity 95%non-condensing
Enclosure Type 3R
Terminal Block Temperature 212°F(100°C)
Rating
Maximum Charging Stations per 24.Each non-gateway station must be located within 150 feet"line of sight"of a gateway station.
802.15.4 Radio Group -
Approximate Shipping Weight 45 lbs(20.4 kg)
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