13110041 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21406 RUWORD DR CONTRACTOR:GREENTECH ELECTRIC PERMIT NO:13110041
OWNER'S NAME: NIKHIL JUNANKAR 12333 SARATOGA SUNNYVALE RD DATE ISSUED:11/07/2013
OWNER'S PHONE: 4082574094 SARATOGA,CA 95070 PHONE NO:(408)280-1180
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESH)ENTIAL COMMERCIAL
License Class
C—I D/ Lic.,#�Ccs:DS7 9(-) INSTALL EVC STATION IN GARAGE 9 KW
Contractor Date
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:$500
I have and will maintain Worker's Compensation hisurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this APN Number:32641010.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the aboveinformation is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 0 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 DA M 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 ��
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations per'the Cu rtm' Municipal Code,Section
9.18.
RE-ROOFS:
Signatu Date 3 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
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 isnot 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 2�25531andSection 3700 of the Labor Code,for the performance of the work for which thisOwner or authorized agen' Dated 4.1- t
permit is issued. 1—Tr
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 �,
10300 TORRE AVENUE-CUPERTI NO,CA 95014-3255 (1
GUPERTINO (408)777-3228-FAX(408)777-3333-buildingOmpertino.org
PRO]ECCADDRESS f/#0& /?UAI FORD D/:?/v4aPNe Ll j 0 1 `o '
O1" rr"ME POONA M 1-(ARKHAN/s 46a-,--2S j- C 1'
STREET ADDRESS Y Q CITY.STATE Z W a/�ti 7 I RT/N V CA
COMACT NaME JENN/EER CH AN PHS �8 R80 //�0 �"II �9 c 7 o cliff.
.�y� Cyd M
STREET ADDRESS / 333 CARA,v A Y , QIY.STATE,Mp 6ARATO6 A, aA FAX
E3 OWNER NER
R ❑ OW -sun.DER 13owmm Acwcr cam RACTOR ❑COMRAcmit AawT ❑ ARQinwr ❑ENomEER ❑ DEVELOPER ❑TPNAwr
cow ACroR NAME /r ,A/�// E /�/1 AYrI Nd LICENSE NUIMER/,j�7e�Q3O MMM fir/O BUS."32-2-8'&
IC 8`3 Z2-8'&
COMPANYNAMEQR/re�,ffA17-rW`.vEl TRIC, EMAB / `p�/V�Ovi r ChelecfricfiFCS eem
S IREET ADDRESS/233V, LrE R SM crrY,STATE-'3pSA
¢� O(A, 02.4 qZ D' /a'd
ARCWMCT/ENG]NUR NAME UCENS£NUMBER BUS LIC B
COMPANY NAME E-MAX FAX
STREET ADDRESS CtrY.SLATE,MP PHONE
USE OF SFD or Duplex ❑ Multi-Family PROIECr n4 wBZLArro PROMCr IN
rmucrm; ❑ Commercial URBAN INTERFACE AREA ❑ Yes `� No FLOW kQNE ❑ Yes ❑ No
❑SOLAR PANELS ELECTRIC VEHICLE CHARwn SrATIoN ❑ SOIAR WATER HFATING ❑ anmL.
FOR SOUR PANELS: NUMBER OF PANELS/JWM- KIIAW (CObIIdERClAL ONLYr TO/�TALVALUAMON:
DFSCRIEMONor WORK /'Vv?". / 410 4A4P Ell cr/ '•r L O G/� //V 6A RA61
s =Ad
�
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By my signature below,I certify to each of the following: I am the property owner of authorized agent to act on theWVjy owner's behalf,I have read this
application and the information I have provided is correct I have read the Description ofWork and verify it is agree to comply with all applicable local
ordinances and state laws relating to buil ' g:construction. I aufho" n Alves of to enter the above- of property for inspection purposes.
Signature of Applicant/Agent' Date
LEMEN'PAL INF TION REQUIRED
z�
NAKWAR�
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PVApp 201 Ldoc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 21406 rumford dr DATE: 11/07/2013 REVIEWED BY: Mendez
APN: BP#: "VALUATION: $500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex PENTAMATION SOLAR-RES
USE: P PERMIT TYPE:
WORK install evc station in garage 9 kw
SCOPE
�,�tt h
WE
L1ech. flan CheckPlumb, Plan C'he'ck Elec.Plan Check
Xtech.Permit Fee: Plumb.Permit I ire: I'lec•. Permit Fee:
C)ther c1s'ech.Insp. Other Plumb Insp. Li Other Elea.Insp.
Aaech.Insp..Fee: Plumb. Insp. ree: Elec.Insp,F'ee:
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 prelimina information available and are only an estimate. Contact the De t or addn7 info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1 # Alternative Energy System
Suppl.PC Fee: (F) Reg. ® OT ro--fl hrs $0.00 $106.00 1CHRGSTA EV Charging Station
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee-.0 Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Consiruction-Tax: F-1
Administrative Fee:
Work Without Permit? ®Yes (E) No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential
Building or Structure 0
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$106.00 �a � sk $107.50
Revised: 10/01/2013
EXISTING 100AMP POONAM KARKHANIS
SUBPANEL 21406 RUMFORD DRIVE
CUPERTINO,CA 95014
19:6"
SCOPE OF WORK:INSTALL(1)40 AMP/240V CIRCUIT
40AMP EVSE-RS BREAKER IN EXISTING UTILITY PANEL,INSTALL 30 FEET OR
INSTALL LOCATION LESS OF FEEDE UU ANEL-T LL•07 Q
cdiAG�t'N��opgl�.�qo�oT�Ir'�'v�l a �� �' �'��NT
EXISTIN�i ASE LC�E�IRf'�Is -�"" "('JO
3/4"EMT CONDUIT
AF il-E E U V LD
This set of plans and specfications MUST be kept at the
2-CAR GARAGE SPACE •B job si':''during const,;S tion. it Is unlawful to make any
� :
c-iar,er c'.alter )I,,same,or to deviate
therefrom,w gL1,1out a.proval from the Building Official.
Th -': nr^g cf this r iw; icosHfa !- NOT
Lc
il(;t i. ^,iii?ll or ti`?r 1 Jr�val Of til:u ViG?.:' 10f1
EXISTING125AMP 0 Ealy�r 'v'I iJi13 of&.1y'vl'Ly v'idinance or Stat-Law.
MAIN SERVICE BY
DRIVEWAY
PL i„il f i I0
GREEN TECH ELECTRIC SOLUTIONS
12333 SARATOGA-SUNNYVALE ROAD,SUITE M
SARATOGA,CA 95070
+5111 Q a
7211"!e
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LOAD CALCULATION Poonam Karkhanis
21406 Rumford Drive,Cupertino, CA 95014
PREPARED BY:
( Green Tech Electric Solutions Inc,)
LOAD TYPE: QUANTITY LOAD TOTAL UNIT
LAUNDRY CIRCUIT: 1 1500 1500 WATTS
APPLIANCE CIRCUITS: 3 1500 4500 WATTS
GENERAL LIGHTING: sq.ft 2080 3va 6240 WATTS
OVEN: 1 5500 5500 WATTS
MICROWAVE: 1 1500 1500 WATTS
DISHWASHER: 1 1300 1300 WATTS
GARBAGE DISPOSAL: 1 900 900 WATTS
REFRIGERATOR: 1 1500 1500 WATTS
HOOE FAN: 1 300 300 WATTS
DRYER 1 5500 5500 WATTS
AIR CONDITIONING UNIT: 100% DEMAND FACTOR 0 0 WATTS
28740
DEMAND CALCULATIONS 10KVA AT 100% DEMAND FACTOR 10000
REMAINDER AT 40% DEMAND FACTOR 18740 VOLT-AMPS MULTIPLIED BY 40% TOTAL 7496
AIR CONDITIONING UNIT: 100% DEMAND FACTOR. 0
EVSE @125% 240v x 30AMPS=7200x125%= 9000
TOTAL DEMAND FOR OTHER LOADS 17,496
EXISTING SERVICE SIZE AT 240V SINGLE PHASE SERVICE UPERTINO
72.9
r L3 P gilding Department
REQUIRED 1r - ', 100
b 2013
NCS
4 ODE COMM/PLIA
http:"www,cityotaloalto,org/civicax/filebank/docurnents/30700
VSE TMEE LM DIAGRAM F2fflDlNML
Cod*Type; odcut Tom: EM T
Vie. Condi Sim: .� Cady Type; E M r
Plum: ,. Conddt
CWS .2L'�
W"fir: f H H IV
VnWke Sim:
— ------ � s. type: TH H N
# of
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aid:# /0EV4ment
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V&D1 � � _ #
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Tice:
100
rim AMP ' C.
pond hnel
REQ.) ,.
'# W � � ejsc� Ate; 1DO �ci�,ear: AERpVlRpN NT
model: �1/SE- RS
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C to be El wan mounted
an
Breaker or
&tmVW xcrm
;dim: 40 Lo Pedit
Building Department
NO 0 2013
REVIEWED FOR CODE COMPLIANCE
3 of4 Reviewed By:
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' 42011 AeFOV"Wonment Inc all rights reserved
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Home Charging Dock
charges all SAEJ1772-compriiant
FEATURES .
;.��; . .,,;r-� °k;:;�•��- vehicles—including both elecb-ic
vehicle(M and p6g4n hybrid
• SAE J1772 oQmpGant ; :°` ('HEV?models—in'the convenience
`t.. d � of the home garage.workplace
• Auto restart in event of power outage or con dominium,apartment,or retail
91°vd
r parking structure.The Home Charging
• Americans with DbabWes Act(AM' Dods safely and reliably delivers
oompGarot in�allatiorr
AC power to the vehicle's cm-board
• InWirated Oble stowagq,optional charger and features a weather-
cable,management resistant NEMA 4 enclosure for indoor
• Underwriters L-Jxwatioty Wlj Isted and outdoor installations.
Breakaway �
.� s3em,cable.. r,�,�,,,,,,,ar.�,,,r,: •
•
Optional pe_astral m*x*
Wirshm oor munication aption The Home Charging Dods is instated by one of our independent certified
r licensed elms who also facilitate necessary permitting and inspection,
' and proWde,kdbrmation about EVSE4tS use to the customer.An optional
SERVICE A+iNSTALLAMON module is used to enable MR Zigbee:or cellular communication.
Will be suppof Wd by:
Expanding network of kWeperrdent
certified trained
• Convenimthome site assessrrherMs v.`s�i e S ', f� Ct�`c sir=q h�a C6fa16Cref�
and kLgw aeon 6RmV=teadytaapetaha
• Be" of local Dods and 6REM trt.tNK W="orsm due to a arariaar sroP
petalr}�y�� c„ e6.bRl lm coxinertOd tD vQ icle ..).c(.,,....,
"'�""g �__— �'"r''� �`= rYl )fi '."RM""'o'IFW
ry F"Ar,u.: r' ItYfSlalKalbWtlFekpl _\�., )
RM=eROrriuomffreitbkkki9Pat mbasedmlrauktype.
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1010_10147 f �'-it e^ ::Y p•.£? �..._. ,.- f. }�
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This guide is a reference for Municipalities inquiring about the use,installation and compliance of
the Aert, ent EVSIE-RS with the National Electric Code and Local Codes.
AeroronneM Inc.Model EVSE4U
Prod .
The LVE46 is a device which offers simple and safe way providing electricity to the
on-boadarrger in an Electric V
I
NEW No,Corrralianc�
t --
Protection gl1 ►'n A systern of personnel 'on devices and
I fearres that wh used together protection against electric shock
S Lamed or LWkderk UL
2594
• .•9 91+ ic:Velrlde Geupler; 1772 coupler SAE N American standard
• Vete Supply �uipment: Perna connected and fastened In
• P ce.No e> a d'he p�
• 4
PAtft 30 amp output to t1n&Continuous load
j (A)For'BecWc Vehide U Only(Denoted on Label)
f- (6)Venftuon not rvequi (Denoted on fVSE Label)
lwleans air uctive J1M rand EVT rated cable
. .17 Cabal Wrraged cable Meavy usage
•
481M odL-Pr�airolty de-ends when plugged
• Iluborna* df-CAW Cable away feature.
OVOW currers Shall be sued for nous duty 12S S-40A Circuit
ker
• PradmitY GFI Protection,Breakaway cable,
T1, able annundation: far- and NEMA 3 Rain enclosure.
• � ngMean= electricvehhide
• "pment mated more than 60 parrs or mane than
v fts to ground,thud' :'I..meats shall be " ed
• a:d installed In a reafty logon.
.25 Loss of Prirrmraay Source char opens upon of power_
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INS iALLING
THE EV"SE-RS
Spec fications:
For use with Elecft VehUm
'Ventlik�.OTl not required
■NEMA Type 3 Rain'r#d enclosure
■40.Amp, circuit breaker rating. Do NOT use a Class A circuit breaker with the
_EVSI�RO.Charting Dock.
-1 yri
50
Pourer Disconnect switch Charging Dock
(dappk")
waa stud
40"Olft
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VU7�i;
R!
V-.,j 4 Ogg,
0 H .0-01 g
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3. Att ch the Charging Dock to the mounting plate
a. T roque the SMw to 40 in/ib
Upper mounting fiofe Ffar K►astrer socket bead sc:new
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4. Wir the Charging Dock
a. T ue the terminal block screws to 20 irL&
b. T ue the Grounding Strip screws to 20 inAb.
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:Gerund Strom
jGround Wire
Tw power wines
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5. Ins all the front corer
#10 TOM SCM&S.-Torque 1 ZffIAb
OEM
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Rene wng the mm ring
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6- Co plete the installation
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SPECIFICATION EVSE 41S
Conn SAE J1772
V 208VAC do 240VAC
FretUe►xY SDW/60Hz
Z
30A max
tng Tempest" 30"Cto SO"C
.StorarjetTransitTeMperature . 40°*Cfio.6(rC
Hmni* Up to 9S%non-condensing
Di 12"x 12"x W{approximate)
w� 10 lbs.*-IOCL cable)
• t� Up to 25'available
Er •
m NEMA 4
R qu"Compliance UL listed,CSA and CE pending
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