15050157 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10029 OAKLEAF PL CONTRACTOR:CINNAMON SOLAR INC PERMIT NO: 15050157
OWNER'S NAME: JOSEPH M AND LINDA S WEISS TRUSTEE 1550 DELL AVE STE K DATE ISSUED:05/29/2015
OWNER'S PHONE: 4082536878 CAMPBELL,CA 95008 PHONE NO:(408)883-7000
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑
`` INSTALL 28 ROOF TOP,FLUSH MOUNTED PV MODULES
License Class Lie.to 0(O� (7.OKW)&INSTALL(N)SUB PANEL(100AMP)IN SIDE
r YARD AREA
Contractor(4 KA-ka 1JV � 6f Date
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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$23700
1 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:32618056.00 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 FROM 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 Issued by <V �// �-� 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.
RE-ROOFS:
Signature Date 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:
7 hereby affirm that 1 am exempt from the Contractor's License Law for one of
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)
1,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,Sectio 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this 2
Owner or authorized agent: YYt6Y\ate:
permit is issued.
I certify that in the performance of the work for which this permit is issued,l 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,1 must 1 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•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buiidingCcDcupertino.org 50
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❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 03 CONTRACTOR ❑CONrRACTOR AGENT ❑ ARCHITE
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PROJECT IN
USE OF [I SFDorDuplex ❑ Multi-Family PROJECT IN WILDLAND FLOOD ZONE Yes 13—N0
❑ SIO ❑
STRUCTURE: ❑ Commercial URBAN INTERFACE AREA Yes
/NS1:1 SOLAR WATER HEATING ❑ OTHER:
SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION
KILOWATTS(COMMERCIAL ONLY): I I TOTAL VALUATION-_f SOLAR PANELS: NUMBER OF PANELS/UNITS: VV
DESCRIPTION OF WORK
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By my signature below,I certify to each f the
hMowinis g: I ha ehread the Dese property cription of Work and verify er or authorized agent to it is accurate.pI agree oecomply awith all applicable local
application and the information I have provided
ordinances and state laws relating to nstruction. I hon a representatives of Cupertino to enter the above-i entified p operty for inspection purposes.
1 Date:
Signature ofApplicant/Agent:
SUPPLE NTALINFORMATION REQUIRED
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PVApp_2011.doc revised 03/16111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10029 OAKLEAF PL DATE: 05/26/2015 REVIEWED BY: MELISSA
APN: 326 18 056 BP#: '�� *VALUATION: 1$23,700
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD or Du lex PENTAMATION
USE: p PERMIT TYPE: SOLAR-RES
WORK INSTALL 28 ROOF TOP FLUSH MOUNTED PV MODULES (7.0kM 8e INSTALL N SUB PANEL
SCOPE (100AMP) IN SIDE YARD AREA
'110;}+.
+#
�o h,e,;�.ld�'�+ 'fi :_. .r'�<e fink..y,,�i� !'u+.:, .x�� ';,•�! u�,ir,.,`�`hv,� L� a��1,o,�r� � 4�v.�,-`�5i��,�''a $ ,ryr4 w;.,.
fi :3�.
l•ri '�S?l'" A..ra'tl x;J.tS.� `�z�'='kk ..z:.v,k:,*A F ..e Y n,:.n3hiF`x aAnr.+ _..s'v-�r ae�w�,.]YRix;w nt esti r, '�4
_..k��a.,:e x, r�eie:.ae�.:� �
Plan Onwk ('/un,h. Plan(hcc`i. Elec.Plan Check 0.0 hrs $0.00
1<1cc/,. Pern,u Fee: 1'lunnb. P nnif Fee: Elec.Permit Fee: IEPERMIT
0/wr r1lcch. lrup. r7nc�•r•Plumb h,,.;Tf Other Elec.Insp. 0.0 hrs $48.00
J•lrc;z. hap. J,e . Phewb. Insp. Fvdc : hlec..IrLanFee
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info,
FEE ITEMS (Fee Resolution 11-053 E f 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Alternative Energy System
Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $236.00 IPHOTOVRES Photovoltaic System
PME Plan Check: $0.00 F 100 amps Electrical
Permit Fee: $0.00 $48.00 IBELEC200 Services
Suppl. Insp.Fee.-(j) Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $48.00
C:oitsmuctinr, TOO
Administrative Fee: IADMIN $45.00 0
Work Without Permit? Yes (j) No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Documentation Fee: ITRA VDOC $48.00 Building or Structure 0
i
Strong Motion Fee: IBSEISMICR $3.08 Select an Administrative Item
Blda Stds Commission Fee: IBCBSC $1.00
MJti K 'H„.ra I a �^�, � }r - ! ,e a - a �, r r fix; 3 aM n't
sV ,�� F '�7 x,14 r TUTSE1:T^`� 429.08
3 S><JB'> OT�TB $145.08 $284.00 •R
s4 �... � '-'! !t. s wtt
Revised: 05/07/2015