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15070157CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1173 HUNTERSTON PL CONTRACTOR: REC SOLAR, INC. PERMIT NO: 15070157 OWNER'S NAME: LORY HOLLY A 775 FIERO LN STE 200 DATE ISSUED: 07/22/2015 OWNER'S PHONE: 4084462163 SAN LUIS OBISPO, CA 93401 PHONE NO: (888)657-6527 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ �g �®I Q (. License Class.+` !/+y INSTALL NEW PV SOLAR MOUNTED -10 PANELS (2.75 # K �Liie. "� Contractor SW �c d E�7i+ S/�_. 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 Sq. Ft Floor Area: Valuation: $5800 performance of the work for which this permit is issued. 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 permit is issued. APN Number: 36221019.00 Occupancy Type: 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 to building construction, and hereby authorize representatives of this city to enter WITI�N 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 D S FROM LAST CALLED INSPEfTIO14. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which ma accrue against said City in consequence of the �,Date• 5N.W granting of this permit. A tionally the a plicant understands and will comply Issued by:YW� with all non -poi urc egulati s t e C rtino Municipal Code, Section 9.18. Signature �1 Date %—a�ia2—%� RE -ROOFS: 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. ElOWNER-BUILDERDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 Ar Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupe no Mu ' ip Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sec ' 05,25 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner Date: 7 RR_ j permit is issued. or authorized agent: 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 (See. 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 • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 ^ buildinclaacupertino.org j5wls� 5+31; sTt PROJECT ADDRESS ® � 7 /G�� / �� �� - �N� �g g OWNER NAME VLl6�k PHONE �4�GJfIJ,ylj/�/^ q�� E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAMEPHOt `�f/� / v � l"L>' _3°%g- G E MAI, /?`1 ill 0/'A' ea STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER 0) � %� J� LICENSE'TYi E ` BUS. LIC # COMPANY NAME �; J�u ( vL iu �v E-MA_IL d � o` .. %�1 •i� � �i'& L'°��f I � Edi Y8 L?��Q�a•���i$ FA7C STREET ADDRESS `fp /� �� �!W CITY, STA, P ( " //) /` j ✓�� / PHONE ARCHITECT/ENGMT ER NAME LICENSE NUI 4B ER BUS. LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ NO FLOOD ZONE ❑ Yes ❑ NO SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PAA'EL.S: NUMBER OF PANELS/IJNITS: KILOWATTS (COMT4ERCIAL ONLY): TOTAL VALUATIO Z_������ DESCRIPTION OF WORK j /) e k�.�4'�� :iTa -or: ? . :a' -? ,:.' ..x -.a "k'i'.; *'".c'�.;w�•�j .. By my signature below, I certify to each a i wing^, I am theeypf e own r authorized agent to act on the property owner's behalf. I have read this application the information I have and provid is correct. I have �e i th �s Iption of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil - con ruction. I authorize .e resentatives of Cupertino to enter the above-identifiedproperty for inspection purposes. Signature of Applicant/Agent: ----- Date: wPPLEIvIENTAL INFORMATION REQUIRED �.ON - � * �� RV N 1N 011s3"y..-tW Pl/tlpp_2011.doc revised 03/16/11 kle C.'O' CITY OF CUPERTINO rml_� FEE ESTIMATOR - RITII,nIN nrv>rcTrnv ,tlech. Plan Check ;Llech. Pennit Fete: Other Akwh. Trap. ;11ech. Irzsp. Fee: PlrunG. Plan Check l'le rnh. Permii Fee: Other Plurnh Insp. Phernlz hrap. Fee: Elec. Plan (`heck I lec. Permii Fee: Other Elec. Imp, Elec. Insp. hl e: NUIE: iHis estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District.etc.). 7%te.Qe %a.0 QYa hOSO/l /7N 1110 »TO%irs�innnr iwinrssan}inn nvnitn%i0 nwil Oro nc�/ r n acfiss�nfn s�fnn} }jun Tlnn} r nddss �I :x% FEE ITEMS (Fee Resolution I1-053 Eff.' 7/1/13) ADDRESS: 1173 HUNTERSTON PL.IlaDATE: 07/22/2015 REVIEWED BY: PAUL APN: 362 21 019 BP#: *VALUATION: 1$5,800 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: Suppl. PC Fee: (j) Reg. 0 OT PENTAMATION SOLAR -RES PERMIT TYPE: WORK Install new PV solar mounted - 10 Panels 2.75 K SCOPE ,tlech. Plan Check ;Llech. Pennit Fete: Other Akwh. Trap. ;11ech. Irzsp. Fee: PlrunG. Plan Check l'le rnh. Permii Fee: Other Plurnh Insp. Phernlz hrap. Fee: Elec. Plan (`heck I lec. Permii Fee: Other Elec. Imp, Elec. Insp. hl e: NUIE: iHis estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District.etc.). 7%te.Qe %a.0 QYa hOSO/l /7N 1110 »TO%irs�innnr iwinrssan}inn nvnitn%i0 nwil Oro nc�/ r n acfiss�nfn s�fnn} }jun Tlnn} r nddss �I :x% FEE ITEMS (Fee Resolution I1-053 Eff.' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $236.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: 0 E) Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) C) 1 i'C!i'el 11 Cl t'Ll7Ylti:YLIQt7l1YJ Fees:� Strong Motion Fee: 1BSEISMICR $0.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS.'` $1.75 $236.00 TOTAL FEE, $237.75 Revised: 07/02/2015 CUPERTINO Address /17 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a)cupertino.org IE FIl`ALED AND CO-M-PLFTED !I TIL THIS CERTIFICATE AND IZFT T ,-, D TO THE BUIL.DING DIVISION PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon. Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. with the terms and conditions of this statement Smoke and CO form.doc revised 03/18114