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13060228 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10160 HILLCREST RD CONTRACTOR:SOLAROPOLY INC DBA PERMIT NO:13060228 SOLAR UNIVERSE OWNER'S NAME: STEPHEN J GROSS P 0 BOX 110536 DATE ISSUED:06/28/2013 OWNER'S PHONE: 4083433115 CAMPBELL,CA 95011 PHONE NO:(408)579-1700 L.l" LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class C(0 Lic.# q 3 ore r 2 INSTALL 39 PANEL ROOFMOUNT GRID-TIED SYSTEM r� _ 1 }{ 10.41KW Contractor Iry 6- /V14 Vie n'1 -) Date at-/1? I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of 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:$43246 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:32616071.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS R) LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the41.2013 granting of this permit. Additionally,the applicant understands and will comply Issued by: j Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature - Date UV.Q a`$ 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. 0 OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I 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 Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 255 ,25533,and 25534. • Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: IA,oZ' 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,after making this certificate of exemption,I CONSTRUCTION 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 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 0.1 n2") A E `y,,yr„ 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingecupertino.orq e PROJECT ADDRESS ( I I'th/ ( (o 0(1.` Ca-Ply y , APN# 3 �C g©g4--' OWNER NAMX, PHONE E-MAIL d `f RPh F ('S Ci 1Z.o_'S i7'' 34-31 IIs <7v c 0 f�7,6 STREET ADDRESS CITY, STATE,ZIP 9 FAX ( iJ l'(. .' ) r (b zAl0 CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER 0 OWNER-BUILDER /❑� OWNER AGENT 0 CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT ❑ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME �--�(/p,OJ O n ( J C LICENSE N'ERO X'2 LICENSE TYPE BUS.LIC# i e9 COMPANY NE-MAIL FAX n/CL.ri - � V '•V aft �. 7J1],/'( '(JrMv���Y1a C l"Civ cola,-Dv� log +2‘ !" STREET ADDRESS CITY,STATE,1IP PHONE `3; 0.f(0-)14-/kiVA c% / 5054— 4i,3.5.,.. (fid ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME - E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF 0 SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: 0 Commercial URBAN INTERFACE AREA 0 Yes 0 No FLOOD ZONE 0 Yes 0 No [OLAR PANELS 0 ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER: OR SOLAR PANELS: NUMBER OFPANELS/UNITS: 3 cp 1 �mr.eI,KII.OWATTS(CO�Smmtit2IALONII�Y):'so I �( 9 TOTALVALUA�IOj 3 /�H, DESCRIPTION OF WORK (JQ� 41C an'I_`vn K //jam! G/L 1124)of H cu.-,c4-5-y)N-4. .--ec-lv,:i ` r l,e - . ` .,cm t fie' t ,,,,,,,,,v k f "+ `k By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on th= .rope, owner's ehalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. et"•ree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: s Date: _ _• ,. — 4-- _ j 3 SUPPLEMENTAL B TION REQUIRED p HC tISE ply FA ,,it,;.;,..ae ... S',,R TI G'UIINTEIt t EXP S , as n s STANDARD e ��� � LARGE; t s roY�9�i� w�� ) r. .. St la PVApp_2011.doc revised 03/16/11 CITY OF CUPERTINO :~k,`e � FEE ESTIMATOR—BUILDING DIVISION ., ADDRESS: DATE: 06/28/2013 REVIEWED BY: mendez -,F=`''°t`- APN: - BP#: *VALUATION: $43,246 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: SOLAR-RES4 wow( install 39 panel pv system SCOPE 4 _ -ter. u 11 _ Mec;h. Plan t'heck .Plumb.Plan Check I Ic _ Elec.Plan Check I I ..LMech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: Other ;heel.Insp. n Other Plumb Insp. F-1 Other Elee.Inspn tlech• Inch.Fcae: Plumb. Insp.Fee: Elee.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 I 1 I # Alternative Energy System Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $219.00 1PHOTOVRES Photovoltaic System PME Plan Check: $0.00 • Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax. Administrative Fee: Work Without Permit? 0 Yes a No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fees: Building or Structure0 Strong Motion.Fee: 1BSEISMICR $4.32 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 e'er kA-.."..444 �'' t �" ' 4�i Tr 6+rnr G tar k '.'➢ ',1 $6.32 $219.00 , (7TAL t E _ $225.32 -14w44'4,-47-4----4:v.. v:�u, ..r,. ;., :.s.:,. �-? .t5.. .+?.-.- .' 2,'t Revised: 04/29/2013 EN 1 US I US 255-260 W Solar module aleo S_79 ulr ,. -_.. _ ,,„yte S ",w ” �. ,„ ,�,r'� Buz ` }ab' 4' v fi fp r7 5�� S ', e% �x x 0` ii, m # 4 * High Efficiency High performance ** H C Efficient use of sunlight due to aleo's commitment to strong performance makes E unique combination of module components this module even more efficient through a unique combination of components.Whether it's standing Elegant design upto strongwinds,heavysnow loads,salt mist, 11 Black frame,black cells � and black back sheet or agricultural ammonia emissions,the S_79 ulr delivers great energy yields over the long term, Everything from even under the harshest conditions.Independent a single source institutes have confirmed and certified their qual- System planning support, financing,training,as well as ity.The S_79 ulr is distinguished by its attractive industry-leading balance of all-black design. aleo modules are sorted with a system components positive power classification.The aleo solar output Comprehensive warranty is for 25 years,while the product war- quality management it 1' Production in accordance with ranty is for 10 years. International quality and environmental standards such as p� ISO 9001 and ISO 14001,as well �1 tl�����t 0 as strict internal Inspections • lip �3uilding DePa�nent Worldwide distribution `�_� and certifications 1(�' 2 2 CSA(UL 1703 3rd Ed and ,/' ip 1 ULCVDE(IEC 61 15 Ed.2 ,�__�___1 JUN VDE(IEC 61215 Ed.2, CODE CO�p��pNCE IEC 61730-1 Ed.1 and ED FOR IEC 61730-2 Ed.I), REVIEW B ��� 1.1,1.7-,,,,,i, California Energy Commission Our modules-Quality you can depend on listing Reviewed Y� CE & ctii& El Contact:aleo solar North America Inc. i 9;f:9 18' Street Suite 120U SoJlh aleo Denver,CO 80202 i USP i www.aleo-solar.com Laboratory Tested FastJack® 2,3591bs 4 1 , ,..,,,, F stJacVertical Pullout./ ,,, 808 lbs E , „ Side 1lxial Pullout! I a a Patent#6,360,491 a Flashable Roof Stanchion Fastlack® FJ-300-18 The patented design of the Fastlack®can be easily expressed as the most innovative,efficient For Daley®style flashings - and cost-effective tool of it's kind! Between the precision CNC machined base and stanchion along with strict engineering and - it material standards,the Fastlack®has been laboratory tested to provide 2,359 pounds of strength using only a single lag bolt(included)! '' Four Sizes Available! ' ,; s s;,, pi,,� a t -, ,. �; �� !°a ,} ;� Part# F.1-.500-18 4,, e�n�lalia using Obtey®flashmgs((or composition shingle rooftops) Fastlack® FJ-450-18 e n part#FJ-450-18 ' For standard height flashings ';'#,A' a at_ __ 1'! }`of chard flashin!3 for am r osition 8 flat roofto i 5 o' c , Part#f-1,400-18 Serrated base grips the roof �.ap�g r � Ln• fa�iatfllerooftois ' . .. deck toprevent the base '^' q> r�� � Parfi# >_i750-18 from moving while installing ��` . �� �,' �,,,, the lag bolt .� �� 1 � edforScurvetileroofs;and/or double'flashe<I_installations) The Fast Jock®design is covered under Pat.#6,360,491 Using leo.5/16"x 3-1/2"Lag Bolt _®r aI FastJak® available (rated! a# 4,250 lbs.) USED FOR MOUNTING: .� _. --.' . , _�:, .': �.. M, • Photovoltaic Solar Panels Y • � Easy installation • Solar Thermal Panels ® # tek® 3/8"SS • Communication Equipment ^z° Aar' . of fleshings on 3/8"x 3/4" Flat Washer i, �11a ton a,exi Ina �� ,a_ • • SS Hex Bolt lla loa existingroof-to s • Virtually anything needing . 1 ' ' o .}:::444f41,":,,rar See reverse for installation theory structural attachment to a roof! " ,' . , , '1,111,, irecl ,�' z l y The post can be professio nal Standard &Oatey®Flashings installed through S o 1 ... , „„ _ ;4 over the base and under the the top of the inc. , nd 1a�r delicate shingle -.! flashing products �4 ; ,iii .)x ,e, l mmom i (805) 486-4700 �0" , � � , r: '',.i.4..' " n 'fr' (805) 486-4799-fax 4:15'1 t , llerr ' 414.47 1551 S. Rose Ave. . + 4.., p� ♦ '---------- ( -____ h Oxnard, CA 93033 qtyirQfi , 7 e` i ? dot holes -. z a p im-e t--ibiii r-,--'' ting View more info on our - website at: 1. � , lashing to ww rosolar.com �o ' Email us for more information trosolar@'rosolar.com 0 Professional Solar Products,Inc.March 2006.