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15060067—No /'�j"SolarCny. April 20, 2016 Dear Sir or Madam: This letter is to inquire about cancelling the permit for the following customer: Ronen Lahav 18760 Tuggle Ave. Cupertino CA, 95014 Permit # 15060067 The customer has decided to cancel their solar project with SolarCity. We hereby request a refund of fees, If possible. Refund checks can be mailed directly to the following address: ATTN: Iona V1111allba SolarCity Las Vegas 6671 S. Las Vegas Blvd Ste. 300 Las Vegas, NV 89119-3290 If you have any questions or need anything further, please let me know. Sincerely, Marjan Javanmard, Permit Coordinator (650)477-6430 mwavanmard)solarcity.com "1051 ')5 (808)SOL-CFFY r(660)638-1029 SOLAR.CITY.COM 5 Qe�lrvlm Way Sin Mato% CA 94402 T A7 U, 1-' 243 J 11, Q.A Cil B t4MR 104 . GO 66 4 1 , 0 P C C R ILI 64 516, T m f F-'Lp 2 1 oo CITY OF CUPERTINO BUILDING PERMIT INSPECTION CARD ' BUILDING ADDRESS: 18760 TUGGLE AVE CONTRACTOR: SOLARCITY PERMIT NO: 15060067 OWNER'S NAME: LAHAV RONEN 3055 CLEARVIEW WAY DATE ISSUED: 06/09/2015 OWNER'S PHONE: 6502246646 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 INSPECTIONS,',' DATE, ; , :' INSPECT. R BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH FOUNDATION/PIERS/H.D.S. RESIDENTIAL r COMMERCIAL r.1 UFER GROUND PAD/SET BACK-CERT I JOB DESCRIPTION: INSTALL 29 ROOF TOP, FLUSH MOUNTED PV MO LES (7.54 KW) REV # 1 - ADD 4 ADDIT 1� PANELS (FROM 29-TO 33) D INCREASE KW GARAGE SLABS/PREGUNITE POUR NO CONCRETE UNTIL ABOVE'HAS`BEEN SIGNED FROM 7.54 TO 8.58KW - T_ TJ _El /23 /15 UNDERGROUND/SLAB UNDERGROUND PLUMBING UNDERGROUND ELECTRICAL DO NOT POUR FLOOR UNTIL ABOVEHAS BEEN SIGNED UNDERFLOOR PLUMBING UNDERFLOOR MECHANICAL - WILDLAND URBAN INTERFACE FI REA ER# UNDERFLOOR ELECTRICAL UNDERFLOOR FRAMING VENTS TOA GE INSPECTION Call 777-3228 between 7:30 am an _ :30 pm Monday through Friday, at least 24 hours UNDERFLOOR INSULATION ` before required inspection. J address and Permit Numbersiare needed when Pi:ACE NQSUBFLOOR'UNTIL�,ABOVE HAS-BEEN SIGNED w ° .` equesting an inspection. ROOF SHEATHING ROUGH PLUMBING I C ERTINO SANITARY DISTRICT Closed circuit vide inspection of property line'cleanout, point of connection TUBS & SHOWER PAN and street late al required prior to passing FINAL CITY PLUMBING ROUGH MECHANICAL INSPECT N. Call the District (408-253-7071) for an appointment. NO B LDING FINALS INSPECTIONS UNTIL ALL REQUIRED ROUGH ELECTRICAL/POOL BOND FRAMING/STAIRS/B. EGRESS BUSINESS LICENSES ARE OBTAINED INSULATIONIVENTILATION covER?No°woxKuNTH AspdE HAs sEENsi,GNED.r �•- PERMIT XPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT EXTERIOR SHEAR/HOLD DOWN ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. IMPORTANT INTERIOR SHEARMOLD DOWN SHEETROCK/SHEETROCK SHEAR hen a permit has expired, a charge totaling one-half the fees to obtain a new permit ExTERIORLATH/W-sCREED I ust be paid in order to reactivate the permit. If a permit. has been expired for more than one year, a charge totaling the full fees to obtain a new permit must be paid INTERIOR LATH t0 reactivate the permit NO TAPE-OR PLASTER-UNTIL ABOVE HAS BEEN SIGNED SCRATCH COAT NOTES: SEWER/WATER T-BAR/MECH/ELECT ABOVE CEIL FINALS!,", � SPECIAL INSPECTIONS Inspector: Date: ELECTRIC METER RELEASE I GAS TEST/METER RELEASE ROOF INSPECTIONS PRE-INSPECTION: Inspector: Date: TEAR-OFF: Inspector: Date: GRADE - PUBLIC WORKS I FIRE -CALL (408) 37840 10 PLANNING (408) 777-3308 PLYWOOD: Inspector: Date: SANITARY (408) 253-7071 BATTENS: Inspector: Date: ELECTTRICAL IN PROGRESS: Inspector: Date: MECHANICAL FINAL: Inspector: Date: NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR'INSPECTION. * OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY PLUMBING HANDICAP ENERGY I INSPECTOR BUILDING CERTIFICATE OF OCCUPANCY' CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18760 TUGGLE AVE CONTRACTOR: SOLARCITY PERMIT NO: 15060067 OWNER'S NAME: LAHAV RONEN 3055 CLEARVIEW WAY DATE ISSUED: 06/09/2015 O R'S PHONE: 6502246646 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] INSTALL 29 ROOF TOP,FLUSH MOUNTED PV MODULES License Class al (DT Q Lie. # 'M I (� tt (7.54 KW) <� Contractor .,C , tc,_'/ L I } Date O `3 REV # 1- ADD 4 ADDITIONAL PV PANELS (FROM 29 TO 33 PANELS & INCREASE KW TO 8.58KW — ISSUED 7/23/15 1 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: $16500 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: 37527022.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERNIIT 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 WITHIN 180 DAYS O UANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS AST C 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 J granting of this permit. Addition ly, tl applicant understands and will comply Issue( Date: with all non -point source regulgns pi the Cupertino Municipal Code, Section 9.18. Signature L Date (3 5 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-BUH,DER DECLARATION 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 1, 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}}' Code, Chapter 9.12 and have and will maintain Worker's Compensation Insurance, as provided for by p4k.�pal nsI the Health & Safety Code, Sectio25505, 2 53d 25534. Section 3700 of the Labor Code, for the performance of the work for which thist� permit is issued. Owner or authorized agent: Date: s 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13) DDRESS: 10876 TUGGLEAVE PA DATE: 07/23/2015 REVIEWED BY: MELISSA !Vech. Pennl1 FGB: PN: 375 27 022 BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plunrh. hrah. Fee: PENTAMATION 1GENRES PERMIT TYPE: A WORK ADD 4 ADDITIONAL PV PANELS FROM 29 TO 33 AND INCREASE KW FROM 7.54 TO 8.58KW - SCOPE ISSUED 7/23/15 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13) Xfech- Plan Check Plumb. Plun C.'heb'i Elec—Plan Clint/( !Vech. Pennl1 FGB: PIun11, Permil Pee: F,le.c. Permit Fee: Ocher Alcch. IrraT Other Plumb Insp.Lj I Other Elec. Insp. Hach. Insp. Fe-, Plunrh. hrah. Fee: Elec. Ins"). Ace: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 0 hours Plan Check, Hourly $143.00 1STPLNCK Suppl. PC Fee: Q) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-(F)Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruction Tax.- ax:Administrative Administrativefee: 0 G Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential E) Building or Structure 0 %'r�cn�el Dc:c°r�rnentatiar7 Fees:� Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS,° $0.00 $143.00 - = TOTALFEE $143.00 Revised: 07/02/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18760 TUGGLE AVE CONTRACTOR: SOLARCITY PERMIT NO: 15060067 OWNER'S NAME: LAHAV RONEN 3055 CLEARVIEW WAY DATE ISSUED: 06/09/2015 O ER'S PHONE: 6502246646 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E] INSTALL 29 ROOF TOP, FLUSH MOUNTED PV MODULES License Class 0 (t) ) C1 C Lic. # }�' �d � i b y (7.54 KV) Contractor t/ C_ I � Date a_4G( Z 1 5 T 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: $16500 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: 37527022.00 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 WITHIN 180 D T ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save +ROM INSPECTION. ;PALLIE,D 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. Additio Ily, the applicant understands and will comply Is te: / el with all non -point source regu tions pVr the Cupertino Municipal Code, Section 9.18. _��� 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous 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 it Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertin u ' ipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505 553 nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized agent: Dater 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 Lender's Address APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 CITY OF CUPERTINO I�r-FIJI FEE ESTIMATOR — RTTILDIN nivigr"N LMADDRESS: 18760 TUGGLE AVE DATE: 06/09/2015 REVIEWED BY: MELISSA gmN APN: 375 27 022 BP#: b 7 -VALUATION: $16,500 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION SOLAR -RES PERMIT TYPE: WORK INSTALL 29 ROOF TOP FLUSH MOUNTED PV MODULES 7.54 SCOPE PME Plan Check: ivvtC: t ms estimate aoes not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School FEE ITEMS (Fee Resolution 11-053 Ef: 7i1�13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $236.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: (D Reg. 0 OT 0.0 hrs $0.00 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 G Work Without Permit? 0 Yes 1@ No $0.00 Advanced Planning, Fee.--Residential$0.00 Select allon Building or Structure Q i Strong Motion Fee. IBSEISMICR $2.15 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.15 $236.00 TOTAL FEE: 1 $239.15 Revised: 05/07/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18760 TUGGLE AVE CONTRACTOR: SOLARCITY PERMIT NO: 15060067 OWNER'S NAME: LAHAV RONEN 3055 CLEARVIEW WAY DATE ISSUED: 06/09/2015 OWNER'S PHONE: 6502246646 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL 29 ROOF TOP,FLUSH MOUNTED PV MODULES License Classy If) ,(19_0 Lic. # (7.54 KW) Contractor I��/ �1 � Date O REV # 1 - ADD 4 ADDITIONAL PV PANELS (FROM 29 TO 33 s PANELS & INCREASE KW TO 8.58KW — ISSUED 7/23/15 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: $16500 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 APN Number: 37527022.00 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 O + UANCE 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 + AST C 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 - Issue Date: / granting of this permit. Addition ly, applicant understands and will comply with all non -point source regul ns •' the Cupertino Municipal Code, Section ✓ i �. RE -ROOFS: 9.18. % 3 Signature Date fj / 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 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. Worker's Compensation Insurance, for by will maintain compliance with the Cupertino un pal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 2 33 d 25534. I have and will maintain as provided Section 3700 of the Labor Code, for the performance of the work for which this l� Owner or authorized agent: 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 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 CITY OF CUPERTINO P"ME FEE ESTIMATOR - BUILDING DIVISION LVUIl;: this estimate does not mclude,jees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate_ rantart the Wont far addn 1t ;"fa FEE ITEMS (Fee Resolution 11-053 Ef : 7/1/131 ADDRESS: 10876 TUGGLE AVE DATE: 07/23/2015 REVIEWED BY: MELISSA i�le,"h, PerA7F1 I" Y'' APN: 375 27 022 BP#: WALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: "z,rrrr,. Fee: PENTAMATION 1GENRES PERMIT TYPE: WORK ADD 4 ADDITIONAL PV PANELS FROM 29 TO 33 AND INCREASE KW FROM 7.54 TO 8.58KW - SCOPE ISSUED 7/23/15 LVUIl;: this estimate does not mclude,jees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate_ rantart the Wont far addn 1t ;"fa FEE ITEMS (Fee Resolution 11-053 Ef : 7/1/131 IIc�E:h. flora ( 71, Plfumh. Mlon Chef..,I, r:iec, Plan C.;heck i�le,"h, PerA7F1 I" Y'' Plumb. PC P7217 1`E't�:.- i>h:c. %ai?YmtR Fee: Ocher hlech. Ins'n. Other Plumb 7rrsn. C)fher 1.kc. Imp, Li �Vech. lnv-� . Fe -e" "z,rrrr,. Fee: Ins,-, Fie: LVUIl;: this estimate does not mclude,jees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate_ rantart the Wont far addn 1t ;"fa FEE ITEMS (Fee Resolution 11-053 Ef : 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (j) No $0.00 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ("WistT`action 717X' rt:llPZtf'2(.411"iXC7Ve? 1'' >( , E) Work Without Permit? 0 Yes(D No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Q Building or Structure i Strom Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 TOTAL FEE: $143.00 Revised: 07/02/2015 ALTERNATIVE ENERGY PERMIT APPLICATIO�1 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building() cuperlino.ora PROJECT ADDRESS f is 0; Tu_bC{Jic— APNR 7 � OWNER 14AME7 9 PHONE E-MAIL STREET ADDRESS f CITY, STATE, ZIP FAX CONTACT NAME Jl / .1� } 0.C( ✓lJ IV ✓� �'l✓ 0 PHONE � , ll �i � 5v�. t�� -- c E-MAILE- STREET ADDRESS ! / ` f CITY, STATE, ZIP p, , /� , j\l/ci��%/ l�.—i 3(`-A l' C FAX ICI ❑ OR'NER ❑ OWNER -BUILDER ❑ OIAINERAGENT M CoM ACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTR.CT0RNAME LICENSENU16BER LICENSE TYPE BUS. LIOklyC COMPANY NAME &MAIL '�,� � P C.Li•1;„1C�r C•� Cl .S (:) I � v L.�FAX V Wl STREET ADDRESSCITY, S T TE, ZIP C• f Tz�Fc_� t`" (�� �� SLI PHONE )- < �, Esc (tI--���c _ ARCHITECTIENGINEER NAME LICENSE NUMBER I BUS. LIC m COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF Q/SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN ST/RU{ • URE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO l3 SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELSIUNITS: KILOWATTS (COM1,gRCIAL ONLY): TOTAL VALUATION: tt �CC)C�.t C} DESCRIPTION OF WORK - a L: w,_) C � S '>ro ;.�-, SSE k �:' S ¢ c� C,;: . t toex' c� ?c�v� _`.S qua,2 `'i Jo 3 � . A By my signature below, I certify to each of the followins: I am the prg iertyP er or zuthorized agent�fh6g�e—Fty-a s kra] . have read this application and the information I have provided is correct. I have re�/the D`e cription of Work and verify it is acc I-ag ee o comply with all applicable local ordinances and state laws relating to building construction.-I''authoPrA-'�g4esentatives of Cupertino to enter the above -identified property fosf inspection purposes. / Signature of ApplicanJAgent: _ _ �l YDate:. SUPPLEMENTAI�IMIFORMATIONREQUIRED rx° .� +�a.'SI OVER THE'�COTJI��'EJ2 � MIN raj* Q if ❑tARCsE£e.; ' z; U. mg_ PV4pp_2011.doc revised 03/16/11 CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacuper ino.og / O� 00 �— PROJECTADDRESS V ` V c- , APN # 3 2!?- , 0 '7 Z OWNER NAME � J �jE® ^ 1/(T ✓C E-MAIL STREET ADDRESS r 8 o `j� / v c � 5��� 1� ,zlp Q q5©t ej FAX CONTACT NAME Marjan Javanmard PHONE 650.477.6430 E-MAILmjavanmard@solarcity.com STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR IN CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME SolarCity Corporation LICENSE NUMBER88810 `l LICENSE TYPE/+1O BUS. LIUC#28840 COMPANY NAMESOIarCity Corporation E-MAILmjavanmard@solarcity..com FA" STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PHONE 650.477.6430 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF EYSFD or Duplex ❑ Multi -Family STRUCTURE: ElCommercial PROJECT IN WILDLAND URBAN INTERFACE AREA ElYes [INo PROJECT IN FLOOD ZONE ElYes ❑ NO ,J I/ SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: � KILOWATTS (COMMERCIAL ONLY): [ 1 TOTAL VALUATION / c /yam V C.C: �. DESCRIPTION OF WORK Installation (of ) rooftop flush mounted solar panel () kW RECETVED$Y: caer oauthorized agent to a pro ave read this By my signature below, I certify to each of the following: I am the pr eF,crnipticr, application and the information I have provided is correct. I have re he of Work and verify it is a a e. agree to comply with all applicable local ordinances and state laws relating to building construction. I autho e r ntatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENT IN ATIO D OFFICE USE ONLY W ❑ OVER-THE-COUNTER ❑ EXPRESS U ❑ STANDARD U U za ❑ LARGE a ❑ MAJOR PVApp_2011.doc revised 03/16/11 ALTERNATIVE ENERGY PERMIT APPLICATIO COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISIO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildino(a cupertino.ong t/ -S- 06 D Q(? -- PROJECT ADDRESS� � `� � V �L, r,�� I +� � �C. APN A! '%� 7 ✓ v �% � Z OWNERNAME VAe- V-\ L-0, PHONE O Z - E-MAIL STREET ADDRESS j ry o T� (� -A J� I T CITY, STATE ZIP eY 1 i �� CA (}/ r'r FAX 1 � IJ I CONTACT NAME PHONE ^ � � p �p � ^ �(t� E-MAIL STREET ADDRESS r1J V CITY, STATE, ZIP �f / /7�f i T 1❑�ARClHITECT FAX 4q OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMED �aY /7 ; 1 L LICENSE NUMBER I ®` t LICENSE TYP �E� BUS. LIC R �� COMPANY NAME �y E-MAIL `� ` t ICI Y C_I, V�C FAX n STREET ADDRESS 3 dj S }Lr i i� J 1 l TY, ST� �IP �C' \ j L� e ° PHONE _(I,_ C q3O ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC m COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE. USE of SFD or Duplex p Multi -Family STRU URE: ❑ Commercial PROJECT IN WILDLAI�'D URBAN INTERFACE AREA ❑ Yes ❑ No -3 PROJECT IN FLOOD ZONE ❑ Yes ❑ No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION T -so -L: \NATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: :3S KILOWATTS (COMMERCIAL ONLY): Q C "Q TOTAL VALUATION: (8_�a©0.�a DESCRIPTION OF WORK C c__i o 5 fit,0. b civi 't -t S �-Q' C) 3 By my signature below, I certify to each of the following: I am the pr erty er or authorized agent to act on the aver' ave read this application and the information I have provided is correct. I have rea he cription of Work and verify it is acc _ e to comply with al] applicable local ordinances and state laws relating to building construction-rautho entatives of Cupertino to enter the above -identified property fo inspection purposes. SienatureofApplicant/Aeent: / Date: �Aq—a Z SUPPLEDQENTAL TFORMATIONREQUIREDp'CFsEo .: u_ �n��Emil n'l�a-=eliz�},fir} OVER TI�COT7Ttv�'E���E Pi,.4PP_2011.doc revised 03116111