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15060128
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11515 SUNSET SPRING CT CONTRACTOR:ROGERS ELECTRIC PERMIT NO:15060128 OWNER'S NAME: SARIKA&AJAY AGRAWAL 11 AGUA VISTA CT DATE ISSUED:06/18/2015 OWNER'S PHONE: 4084976719 REDWOOD CITY,CA 94062 PHONE NO:(650)346-0981 JOB DESCRIPTION:RESIDENTIAL COMMERCIAL LICENSED CONTRACTOR'S DECLARATION INSTALL(1)EV CHARGING STATION IN GARAGE&A(N) License Class (1 .# p 200 AMP ELECTRICAL PANEL FOR EV CHARGER Contractor Date I hereby affirm that I am licen d 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 rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$I500 have and will maintain Worker's Compensation Insurance,as provided for by tion 3700 of the Labor Code,for the performance of the work for which this APN Number:36652019.00 Occupancy Type: rmit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF T STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 1 OF P 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 1 ED INSPECTION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence o granting of this permit. Additionally,the applicant understands y by: te: with all non-point source regulations per the Cupertino Municip e,Sec 9.18. RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is t5 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: 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 1 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,Sec ons 25505,25533 5534. Section 3700 of the Labor Code,for the performance of the work for which this IMA A 1i A TA i I/Z/" Owner or authorized agent Dat permit is issued. Ue 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 1-icensed Professional 918. 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 • building a(_cupertino.orq CUPERTINO b PROJECT ADDRESS Soneg_f ` APN 4 C OWNERNAME P Ob E-MAIL A V-/1 Ajo' r STREET ADDRESS 64 C Y, STATE,ZIP FAX C3 C4 CONTACT NAME PHONE E-MAIL Aa r C_ com STREET ADDRESS ( Y STATE ZIP 9 FAX ❑ OWNER ❑ OW4'NER-BUILDER ❑ 0%L`NERAGENT ❑ CONTRACTOR ❑CONIRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR 4E ENS L E LIC NSE TYPE BUS.LIC K a<' Lie-46 120 COMPANY NAMEl e E-MAIL FAX STREET ADDRESS rCIT ,STATE,ZIP PH E y ' 1.) *a,,ON . k� C+ F,_1 A-) ARCHITECT/ENGINEER NAl`4E I LICENSE NUMBER BUS.LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family I PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZOITE ❑ Yes ❑ NO ❑SOLAR PANELS ECTRIC VEHICLE CHARGING STATION 7 SOLAR WATER DATING ❑ OTHER: FOR SOLAR PANELS. NUM ER OF PANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): TOTAL V A IQAi:y�.y� DESCRIPTION OF WORK By my signature below,I certify to each of the following: I am the property o%vner or authorized agent to act on the prop ehalf. 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 t u' ing construction. I authorize represent v of Cupertino to enter the a ove-i ntifjeed p ope for inspection purposes. S ignature of Applicant/Azent: Date: ' U�l� 1 S PPLEMENTAL INFORMATION REQUIRED .OFFICE USE ONLY = � 4 '�z DI"OYER T]�CO�JIv'TER PV4pp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION Eli ADDRESS: 11515 SUNSET SPRING CT DATE: 06/18/2015 REVIEWED BY: MELISSA APN: 366 52 019 BP#: "VALUATION: 1$1,500 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION SOLAR-RES USE: I PERMIT TYPE: 19 WORK INSTALL N EV CHARGING STATION IN GARAGE &A N 200 AMP ELECTRICAL PANEL FOR EV SCOPE CHARGER ,tlech. Plan Check Phuub.Plan Check Elec. Plan Check 0.0 hrs $0.00 :llecf; [Plumb rmit Fet Elec. Permit Fee: ]EPERMIT Other Hech. Insp. Other Plumb Insp. Ll _L___ Other Elec.Insp. 0.0 hrs $48.00 Meeh. Insp. Fee: I'Inrnb. hasp. Fcc� klec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments(i.e.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'l info. FEE ITEMS (Fee Resolution 11-053 E ..� 77.73) FEE QTY/FEE7 MISC ITEMS Plan Check Fee: $0.00 1 # Alternative Energy System Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 $109.00 1CHRGSTA EV Charging Station PME Plan Check: $0.00 200 amps Electrical Permit Fee: $0.00 $48.00 IBELEC200 Services Suppl. Insp. Fee:Q Reg. Q OTTO-01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 ("01Nlrr./ctiorr TCIAC Administrative Fee: ]ADMIN $45.00 O Work Without Permit? © Yes (F) No $0.00 0 Advanced Planning Fee. $0.00 Select a Non-Residential 0 Travel Documentation Fee: ITRA VDOC $48.00 Building or Structure 0 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldy,Stds Commission Fee: ]BCBSC $1.00 SUBTOTALS: $142.50 $157.00 TOTAL FEE: $299.50 Revised: 05/07/2015 lYbl-7(y io 7d 0 -3 1p — --- /MdliuQ A uo1leloln aye �� c,uol . 4e 0 2 0n� ION I'IVHS Suo.P�!P OdS pue ue,;i c, „ ` o1 Plaq aq leio 0 6uipinE3 aqj wog 141C JUldwelS ay �4 Vll I/ alelna Ieno�dc.E ZP/J �S .� s/s �tue anew ola I!^ e`un sl suo�;� ;1�� Jo sa6ueyo � 11 'uoi �c�;cupD 1, 9 ' U.tJh (y OA) aUl le lda�aq ISfll'V suo, �o� )[ 6uunp alis qof � �-• PUe sueld jo las sly1 (13nOHCIdV ev b r� ONLL2Gdn0 - ICI -� 1N3W.Layd30.LN3Wd013A30 A-LINnW D atibj� f � � 7 z 9i;?A6 V.2 /?tea' WOU 4 vv� � ✓l/16L C) 3ONd1-ldW00 3010'0 d03 0311�31n3�' StOZ �uauA1eiiaa buQW-, ONU83dno �S N--V 1 V+�V�-f' - Z ON1183d(lo id3a ONINNb^d StOZ 8 t Nnr ,ldP QuZ (7�AS a3A0 S yZ GrJAIa3AX -90(19 zi0 U14"�I,Q�lld 9NI111V VIVW Z - a j w / ck S-nql-,�VldW )uAf/00/- � � �8 Pama/naN JNb1j � oD V9 40_1 r 3M.3//196 QOZ EFIr- �e�dCJ JwNh (1907 -charge,_ _ _ j S ChargePointu Home Ak Installation G Q O V V r p m CD m m -Mr- OLro n O �yV O w W m =' C7 ' n c a C O M RECEIVED n, CD 0 JUN 1 g ZU15 �iY DANGER RISK OF SHOCK Turn off circuit breaker to 240V outlet. DO NOT RESTORE POWER TO OUTLET UNTIL.LAST STEP. Failure to follow these instructions could result A* in shock or electrocution. Remove contents of boxes and rernuve widlo limn Lim i-haigloy stdtwii.1.;Uke Z>ury YQU om6 Ilei missing any parts. Electricians on page E. r'F+-•.�.:nn Ctftti^n Rn x: rh-srninn ('A Box:- Charger Body Outer Cover Installation Template Charging Cable 101 Cable Clip a: ,o: - 101 Wire Cover ® (3)2 X 1/a„ Lag Screws �IMIMIMNMM► 3/e"Driver Bit 3/,e"Drill Bit OW * �� .��. �wwewwM► If you are missing any of these parts,please call 1.888.758.4389 ^V V��4.�"-� "^^�s you will need: �Lr� 6-2C Ty a _«,.MJ• F;rider Level Drill ChargePoint or 6-50 240V Outlet T Mobile App CD ~ � � Pencil ® ® Coin O O OFor an online video of these instructions, go to chargepolnt.com/home or use the ChargePoint mobile app. chargepoint.ccm 3 Using the driver bit,partially install only one of the screws into the'Lop-most rnou,I.1,.y The screw should protrude so that you can hang the station•,cn;+.^e^'t two screws right now—you'll install them later. (1)2"screw / • 6 'ei��ily the station on the protruding screw head using the notch in the back of the station. Don't Niug t G atatio l i..yet. Drive the two bottom screws into the bottom mounting holes to firmly secure the station. Be careful not to damage the electrical wires. i i Side view Front view (2)2"screws 7 Now,take the charging cable and lay the charging connector on the ground. Remove the cab!c clip that's connected to the wire end of the cable,but do not discard it. t,. chargepoint.com 5 Snap the cover plate on the station. .,,oe7 0 111�—� 0 Wrap the charging cable over the top,and plug the connector into the holder. Plug the station into the outlet,and then restore power to the outlet.The white light status light should turn on. U After installing your ChargePoint Home, download the ChargePoint mobile app to �.Hane Charger connect to your charger. chargepoint.com 7 a I . I I --chargepoin+ ChargePoint"Home I Color Status Key Not Connected to Internet i Ready to charge Charging Fault I I I i White Blue pulsing Red Connected to Internet Ready to charge Schedule set Plugged in Charging Fault I I I I I Green Green blinking Blue Blue pulsing Red I To override a set schedule and start charging immediately: I I i 1.Make sure the connector 2. Remove the connector 3. Plug back in within is plugged into the car from the car 7 seconds I I I I I I I Questions'. Visit chargepoint.com/home or call 1.888.758.4389 i i I I I I I I i I t I I I I I i I I cnargepo�nt.com 11