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15010085CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20875 FARGO DR CONTRACTOR: SLINGSHOT POWER INC PERMIT NO: 15010085 OWNER'S NAME: KATHLEEN MITCHELL 164 MAIN ST DATE ISSUED: 01/14/2015 OWNER'S PHONE: 4085294529 LOS ALTOS, CA 94022 PHONE NO: (650) 308-9055 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0 ❑ LICENSED CONTRACTOR'S DECLARATION INSTALL 120 V & 240 V CIRCUITS LOCATED IN GARAGE License Class /'s Lic. # ` 9yY 8 9 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 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32630134 00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 O 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 FR - S CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, accrue against said City in consequence of the '' // Nom• costs, and expenses which may Issued by Date: • granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. Date �` %y' I r ny rROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature 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 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 of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sections 2 �_5, 2525533, and 25534. I �� Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: /_ted( 42, Date: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I 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 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 • building(a)cupertino.orca 150 /U ❑ PLUMBING ❑ MECHANICAL ELECTRICAL Fl MISCELLANEOUS MEP misc PROJECT ADDRESS 0 4 of APN # . OWNER NAME 'r e�G�l PHONE yon_ Sze- vs�y E-MAIL -/1N1/lli�rhiFG4e(�C_ 4 Low STREET ADDRESS ^a�7� �[///�� CITY, STATE, -/I//yS�/y FAX CONTACT NAME/ //n / PHONE � !GI✓G 4vc GC S 7 /�rlG'✓C� $C.:" � est SYj o G/P/, STREET ADDRESS CITY, STATE, ZIP L/mss �� rYmz� FAX ' iso 90- 0 `7 5 El OWNER I -] OWNER -BUILDER❑ OWNER AGENT , ,� 11 CONTRACTOR 131CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �� /r • LICENSE Nre4 g Gl LICENSE TYPE BUS. LIC # 6? COMPANY NAME , // � E-MAII, ^1_g ve FAX � • � o S w� T Gob, STREET ADDRESSz�� C CITY, STATE, ZIP/OS / �U� �� /� PHONE j So _ f � C S C 0 D ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC ## BUS. COMPANY NAME E-MAII FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY PROJECT IN WJLDLAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑ YES BUILDING: ❑ COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO EICHLER HOME? ❑ NO DESCRIPTION OF WORK /10V �Yo✓ lti. �� TOTAL VALUATION:ori RECEii�sD'E3` s 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 read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil/diug.constructio a thorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: ( Date: SUPPLEMENTAL INFORMATION REQUIRED' QFFJCE USE P ',,LY �" x0YE12 TIIL:-COTTER w ,, u �1 Ilk S > yr aFs �s T dRa MEPMiscApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 20875 fargo dr DATE: 01/14/2015 REVIEWED BY: Mendez APN: BP#: *VALUATION: $500 FPERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: WORK install 120 v & 240 v circuits located in garage SCOPE APPLIANCE / EQUIP TYPE Other Power Devices tWeOl. /dart C. kieL`k A,fec:li, P emait Fee: FEE ID 1 BREMPOWER TOTALS: Phwib. Plcert Cheek Plumb. Plum;t Fee: QTY I UNITS 1 1 # BP FEES $179 $179.00 1REAP8 Elec. Plan Check 10.0 1 hrs $0.00 Elec. Permit Fee: IEPERMIT Ins 3. F-1 Oiher Plumb Irup. Li Other Elea Insp. LLOJ hrs $48.00 _ e,Ji t,,st . f;:r phold). Irr.sp. Flee: >iec. Ins, FCO. NOTE: This estimate does not includefees 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 Dept -for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/131 FEE QTY/FEE MISC ITEMS Plan (.,'peek Fee: ;`iztj pl. rr.;(- Fee PME Plan Check: $0.00 C'r.nnit F,'>C: .` jjpj)l. fpsll, Tlee PME Unit Fee: $179.00 PME Permit Fee: $48.00 (,'ons?ru,,iion Tax Administrative Fee: 1ADMIN $45.00 Work Without Permit? 0 Yes (E)No $0.00 111zrrrrarrrtF Fees: -T-= Travel Documentation Fee: 1TRAVDOC $48.00 Strom Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 F� $321.50 $0.00 TOTAL FEE: $321.50 Revised: 08/20/2014 Sheet Index 1 ... Title, Index, and Equipment Mounting Location 2 ... Load Calculations & Electrical Outlet Schematic 3 ... General Notes 4... Electrical Outlet Datasheet Additional Installation manuals, other hardware references and certifications available upon request Permit 2013 California Electrical code; Underwriters Laboratory (UL) listed charging system. As Installation: .EV charging system information: Level 1 or 2, EVSE system with UL listednumber or other pproved nationally recognized testing laboratory, in compliance with UL2202, "Standard )r Electric Vehicle (EV) Charging System Equipment". Existing electrical service panel information at the residence. Include EVSE loadand circuit !e to determine if electric panel upgrade is required. Provide load calculations to Aermine if there is adequate capacity in the existing panel. (CEC220) 2013 I3.Panel upgrade and electrical wiring shall be in conformance with the 2013 California Electrical Code. dentify if a second electric meter is required to be installed because of electricutility rate EV charging. .Clarify EVSE locations (garage, carport, interior, exterior, etc.) EVSE shall be installed in accordance with manufacturer's guideline and must be suitable )r the environment (indoor/outdoor). If the EV charging equipment is located in an area abject to physical (i.e. vehicular) damage and adequate barrier shall be installed. (i.e. 3to " bollard) .Submit installation guideline as part of submittal. lin",Ashoc;A. 164 Main St., Los Altos, CA 94022 P h : 650-308-9055 Fax: 650-887-0345 California State Lic: B984488 Eauinment in this Electrical Outlet Installation slir old t� igsha>t. Own Your Energy - Lacatlkm of 1ffV Chmrgiw Gar*go Iltt to 3ca1le *01 * two Car Date: 14 -Jan -15 Equipment Type Model Version: 1.0 Scale: None 1 NEMA 5-15 Project: 0 1 NEMA 14-50 Drawn: Tony Seng Electrical Outlet Installation Permit wee CGve0 k C,0 ?r - e s' J ufly 1J •iCE COO* IM4� X Slingshot Power, Designer Title Sheet & Sheet Index Project Details: Client: Tim Mitchell Address: 20875 Fargo Drive City: Cupertino, California Page Number: 1 !.',0lY!€+r7i.1Nr I Q:.- Y F T.OPMEMIT D1~ PAR WIF-11147 I3UIl-rD(NO Df\tISION - Ct..Fv'EI~TIN'O APPROVED Thiz set of plans and specifications DUST be kept at thk job site during construction. it is wnlaWail to rnake any ' changes or z't at U s ^ i sa ie, or to devict4 V",ercfro n, ,:' o .t ur , , .... I 4: i t.e E ',d G ikial. S,R i I s l -47 _......._ r utlet__. L Date: 14 -Jan -15 Equipment Type Model Version: 1.0 Scale: None 1 NEMA 5-15 Project: 0 1 NEMA 14-50 Drawn: Tony Seng Electrical Outlet Installation Permit wee CGve0 k C,0 ?r - e s' J ufly 1J •iCE COO* IM4� X Slingshot Power, Designer Title Sheet & Sheet Index Project Details: Client: Tim Mitchell Address: 20875 Fargo Drive City: Cupertino, California Page Number: 1 Standard Method Residential Service Calulation 1.0 General Lighting: 220.1 Total 1650 Sq Ft. 4950 VA Small Appliance: 220.52(a) 2 Circuits x 1500 VA 3000 VA Laundry: 220.52(b) Circuits x 1500 VA 1500 VA Applying Demand Factors: Table 220.42 1st 3000 VA x 100% 3000 VA Next 3000 VA x 35% 1050VA 3450 Remaining VA x 25% 862.5 VA TOTAL.................................................................. 4912.5 VA 2.0 Fixed Appliances: 220.53 "It shall be permissible to apply a demand factor of 75% for four appliances other than eletric ranges, clothes dryers, space heating equip, air-conditioning equip.) YES/NO VA Dishwasher YES. 900,VA Disposer YES CQOsVA { Microwave YES 11 VA Compactor NOVA Pool/Spa NO } e`b d4G zAsdyY�'�: 0 VA Attic Fan I NO Q`VA 5r Other 0 wwb VA TOTAL.................................................................. 1968.75 VA YES/NO VA 3.0 Eletric Dryer: (5000VA) 220.55, Table 220.54 5000 VA x 100% YES ' VA 4.0 Cooking Equipment: Table 220.54 Oven 7200 VA x100% YES ` " _ , VA Range 11000 VA x 100% YES VA Col C kW Other 0 W=VA VA TOTAL.................................................................. 15200 8.0 5.0 Heating or A/C: 220.60 (non-coicident loads) VA Heating unit 1500 VA x 100% NO VA A/C Unit 6000 VA x 100% YES VA Heating Pump 1500 VA 100% NO VA (loads) ............................ Take Largest Load 6.0 Largest Motor 220.14(c) = 430.24 & 440.6 0 VA 1? VA x 25 7.0 EV Charger Level 2 (12000) VA NO 0 VA slingshot 164 Main St., Los Altos, CA 94022 Ph: 650-308-9055 Fax: 650-887-0345 California State Lic: 6984488 ELECTRICAL LOAD TOTAL Service Total VA 1 33081.25 VA/240 I 137.84 Amps X IMJ4� Slingshot Power, Designer Equipment in this Electrical Outlet Installation load Calculations & Electrial Outlet Schematic Charging System Date: 14 -Jan -15 Project Details: Page Number: Equipment Type Model Version: 1.0 Scale: None Client: Tim Mitchell 1NEMA 5-15 Project: 0 Address: 20875 Fargo Drive 2 1 NEMA 14-50 Drawn: Tony Seng City: Cupertino, California V ABBREVIATIONS A ........... Ampere AC ........ Alternating Current BLDG.. Building Structure CONC... Concrete. DC ......... Direct Current EGC....... Equipment Grounding Conductor (E).......... Existing EMT....... Electrical Metal Tubing GALV .... Galvanized GEC....... Grounding Electrode Conductor NTMGND....... Ground HDG....... Hot Dipped Galvanized I .............. Current Imp......... Current At Maximum Power Isc........... Short Circuit Current kVA........ Kilovolt Ampere kW .......... Kilowatt LBW ....... Load Bearing Wall MIN........ Minimum (N) .......... Neutral NEUT..... Neutral NTS ........ Not To Scale OC .......... On Center PL ........... Property Line POI......... Point of Intersection PV .......... Photo Voltaic SCH........ Schedule SS ........... Stainless Steel STC........ Standard Testing Conditions TYP........ Typical 2Pole...... Grounding System(N) & GND UPS........ Uninterruptible Power Supply UFER...... Grounding system to foundation V.............Volt Vmp........ Voltage at Maximum Power Voc......... Voltage at Open Circuit W ............ Watt 3R ........... NEMA 3R, Raintight slingsh<;>t 164 Main St., Los Altos, CA 94022 P h : 650-308-9055 Fax: 650-887-0345 California State Lic: 8984488 LEGEND E) Utility Meter & Warning Label Inverter W/Integrated DC DISCONNECT DC DISCONNECT & WARNING LABELS AC DISCONNECT & WARNING LABELS JUNCTION BOX DC COMBINER BOX & WARNING LABELS DISTRIBUTION PANEL & WARNING LABELS LOAD CENTER & WARNING LABELS DEDICATED PV SYSTEM METER CONDUIT RUN ON EXTERIOR CONDUIT RUN Equipment in this Electrical Outlet Installation Charging System Date: 14 -Jan -15 Equipment Type Model Version: 1.0 Scale: None 1 NEMA 5-15 Project: 0 1 NEMA 14-50 Drawn: Tony Seng UNGROUNDED PANEL 13 POSITIVE GROUNDED PANEL NEGATIVE GROUNDED PANEL MICROINVERTERS THIS PROJECT SHALL COMPLY WITH: THE: 2013 CA BUILDING CODE 2013 CA PLUMBING VODE 2013 CA RESIDENTIAL CODE 2013 CA ENERGY CODE 2013 MECHANICAL CODE 2013 CA CITH / COUNTY FIRE CODE General Notes Project Details: ient: Tim Mitchell ]dress: 20875 Fargo Drive ty: Cupertino, California X "A Slingshot Power, Page Number: 3 M Drawings tures CMax here fcobn . . Operating Tem ' pnt6us 75`C, minimum -WC (w/o impact). gs M -Drawing UPC Number 178359501531 Weight in LBs 0.7 Islingshot 164 Main St., Los Altos, CA 94022 Ph: 650-308-9055 Fax: 650-887-0345 California State Lic: B984488 Equipment in this Electrical Outlet Installation Charging System Equipment Type Model 1 NEMA 5-15 1 NEMA 14-50 w Material Material -y perx"e Teatperamres Drawings ChekhemforM-Drav44ux Q PC Number 78358543522 eight in LBs 10.25 A Slingshot Power, Delnr Electrical Outlet Information Date: 14 -Jan -15 Project Details: Page Number: Version: 1.0 Scale: None Client: Tim Mitchell Project: 0 Address: 20875 Fargo Drive 5 Drawn: Tony Seng City: Cupertino, California