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15060174
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23644 OAK VALLEY RD CONTRACTOR:ALL IN ONE PERMIT NO: 15060174 CONSTRUCTION OWNER'S NAME: DHAMIJA MANISH AND CHANGOTRA MANU 5425 FRASCHINI CIR DATE ISSUED:06/26/2015 OWNER'S PHONE: 4086746382 SAN JOSE,CA 95136 PHONE NO:(408)561-8597 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL /� C3 6 3 �l 6 INSTALL NEW EV CHARGING STATION(50 AMP) License Clas Cto Lic.# Contractor L //t/ t�lDate 62 Zgk4��— 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$600 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 34257023.00 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 D YS FROM LAST C LLED INSPECTIO . 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. Additionally,the applicant understands and will comply Issued by: Date: ' with all non-point source eguI do 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 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. 1 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 t • pertino Mu ode,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,1;! 2 ,and 2 34. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: permit is issued. e2Wf4 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 GENERAL PERMIT APPLICATION e;o&o lP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 W = Isc CUPERTINO (408)777-3228 • FAX(408)777-3333 •building(d)cupertino.org ❑PLUNIBING ❑MECHANICAL VLECTPJCAL ❑ACSCELLANEOUS PROJECT ADDRESS jl/ / I APN R /0 I I IR NAME' _fjy) P Q ,�) E-IVLAIL 614� STREET ADDRESS ,� / CITY, STATE,ZIP FAX CONTACT NAME PHONE E-MAJI, STREET ADDRESS CITY,STATE, ZIP FAX ❑ m\wER ❑ OWNER-BUMDER ❑ OWNERAGE?.'T ❑ CO\7RACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGI\SER ❑ DEVELOPER ❑ IE-NANT CONTKA CT0RNA,M LIC SFj E ICEA'SE E BUS.LIC COMPANY NAME qp / ! � E /L _r� FAX STREET AD S/ CITY,ST, W1 p ARCHITECT/ENGINEER.NAME LICENSE NUMBER BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT LN WII..DL.AND ❑ YES PROTECT IN Cl YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO EICHLER HOMET ❑ NO DESCRIPTION OF W w *''v" ,azo TOTAL VALUATION: &V �RECEIVEDBl r = � By my signature below,I certify to each the fo 0 a: am top q rty owner or authorized agent to act on the operty owner's behalf. I have read this application and the information I hav provid is orr t e read e Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to uil e representatives of Cupertino to enter the above-idea' edro rtyinspection purposes. Signature of Applicant/Agent: Date: p�LljQ SU-PPLEMENTAL INFORMATION REQUIRED ocE usEbr i' '' ;,. ` OVER THE COUTEI2 �t., A7EPATiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO I SO 60 -71� FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 23644 Oak Valley Rd DATE: 06/26/2015 REVIEWED BY: Paul APN: 342 57 023 BP#: 'VALUATION: $600 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PENTAMATION SOLAR-RES USE: PERMIT TYPE: PRIMARY SFD or Duplex WORK Install New EV Charging Station 50 Am SCOPE rlfech. Plan('heck Plumb. Plan Check T Elec.Plan Check 61eclt. Permit Fee: Plumb. Permit Fee Other rllech. Insp. Other Plumb Insp. Li Other Elec.Insp. Li I A,1ech. htsp. Fec Plumb. htsp. T-e" 1:7ec. 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. . These.fees 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 Ef: 7.%1%73) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Alternative Energy System Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 $109.00 1CHRGSTA EV Charging Station PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.-E) Reg. Q OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? O Yes O No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) „iw, .,,, �)r t IF:,,. 1 Building or Structure 0 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldjz Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $109.00 TOTAL FEE: $110.50 Revised: 05/07/2015 'CE 7- -_OMMUNITY JUN 2 6 OFFICE COPY DEVE LOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED House '-his set of plans and spe�iQ�'j�iViUST be kept at the Db site during construction. It is unlawful to make any changes or alterations on same, or to deviate CUPERTINO therefrom, without approval from the Building Official. � Building Department -he Stamping of this plan and specifications SHALL NOT oe held to permit or to be an approval of the violation JUN 2 6 2015 of any visions of any City Ordinance or State Law B Y � �� REVIEWED FOR CODE COMPLIANCE DAT -- 1 --- install a;Tema /4 50 electrja`vlkv/�B�ti� PERMIT # "- - —– - -- Meter;wain Electrical Panel /25 Am Driveway concrete Removed, removed dirt to /8 inches G_ Instal/ed !114 Pvc/or electrical used#6 wire from main to charging station 50 Amp breaker used f�lPCQNR AQ,WM 2013GfU MVIA COX Offtigl 9!706 2013 C41/mm BUIlLANG cLxr 7 2013 CXL115 PiV1A flRf C W ;Vem8 14 50 2013 CAiJMWIA 1VC7WA COX charging station b 0 or Or�t9NeY Phil Blake GYIQV(: .wanlsh Dham/Ja AGf ,r55:23644 Oak valley Road 408 561-8597 All /A / ONf GTY: Cupertino stA>f:X50/4 l�l : 408 674-6382 !K/WIC611 aA55.•a C/0,cm0a9 aWrAPPRWAI .--– A-1 . _�`„'-�•-;-..=�-''"' .SfNf•DRA/'1IS91Ax5A4711U,5�911' ELECTRIC VEHICL CHARGER - LOAD CALCULATION ESTIMATOR Fa THIS FORM TO ESTIMATE IF AN EXISTING ELECTRICAL SERVICE WILL HANDLE THE EXTRA D FROM A VEHICLE CHARGER. (Loads shown are rough estimates;actual loads may vary— for ore precise an is, use the nameplate ratings for appliances and other loads and consult with a trained electrical professional, ) t -./Check Applicable Description of Load Typical Watts used Loads usage GENERAL LI HTING AND RECEPTACLE OUTLET CIRCUITS ✓ Square Footage of House X 3 3 watts/sq. ft. (000 KITCHEN CIRCUITS ✓ Kitch n Circuits 3,000 watts 3,000 Electric oven 2,000 watts vUO Electric stove top 5,000 watts �bo� Microuvave 1,500 watts Sb Garbage Disposal under 1,000 watts kitchen sink Autoniatic Dish washer 3,500 watts B© i Garba e Compactor 1,000 watts n/0 Instantaneous hot water at sink 1500 watts LAUNDRY CIRCUIT ✓ Laundq Circuit 1,500 watts 1,500 Electric Clothes Dryer 4,500 watts HEATI G AND AIR CONDITIONING CIRCUITS Central Heating (gas) and Air 6,000 watts Conditioning Window mounted Air 1,000 watts Conditioner At O Who16L house or attic fan 500 watts p Central Electric Furnace 8,000 watts A10 Eva o�rative, 500 watts OT R gMICAL LOADS fElectric joDlaTr rage 4,000 watts pe M c� Electric n ss Watee".l0ater 15,000 watts AIG Swimrii P6vl or S 3,500 watts j Other: e� 'dcn rn O IOther: n o z I _ 3 Other: .. ELE T VEHICLE CHARGER CIRCUIT Electric Vehicl harger rating* 4000 (Add-up all of the w@rtts for the loads checked✓) TOTAL WATTS USED 4 *Use name plate rating.in watts or calculate as: (Ampere rating of circuit X 240 volts = Watts) i i Page 2 of 5 -- i , *A4: INSTRUCTIONS: Apply the Total Watts Um Page 1 to the Table below to identify if the Existing Electrical Service Paarge enough to handle the added el��I � the Electn Vehic hr# arg r. 44'in imu Rluired Size of Total Watts Used ** Existing 249 Volt Electrical Service Panel _ Main Breaker Size up to 24,000 60 am 24,001 to 48,000 100 ams 48,001 to 63,000 125 ams �I 63,001 to 78,000 150 ams 78,001 to 108,000 200 ams 108,001 to 123,000 225 amp ** Table based on NEC 220.83 (A). Only applicable when adding electrical vehicle charger loads to existing dwelling electrical service. CAUTION: This table is NOT to be used to determine the size of a NEW or UPGRADED Electrical Service Panel if your existing panel is too small or overloaded according the Table above. In order to determine the size of a NEW or UPGRADED Service Panel, there is a completely different load calculation methodology that applies. Sizing of a NEW or UPGRADED Electrical Service Panel should only be done by a qualified Electrical Contractor or Electrical Engineer. STATEMENT OF COMPLIANCE By my signature, I attest that 1 have estimated the electrical loads on the Existing Electrical Service Panel located at 623 coqdel/ ,(2J/�6 (print address) CUjOFE-(,jp and according to California Electrical Code Article 220.83 (A), the existing 9 say electrical service panel is adequate to handle the added electrical load from the Electric Vehicle Charger circuit. TINp, -Q 7� P ar ment (signature of applicant) ( da t Js' �5 YOU MAY WISH TO HHAT IRET A! QUALIFIED INDIVIDUAL VWXPLEASE NOTE IS A VOLUNTARY COMAND cx THOROUGH EVALUATION OF YOUR ELECTRICAL SERV(Q4OF THIS ALTERNATIVE METHODOLOGY. USE OF THIS ELECTR COAD CALCULATION ESTIMATE METHODOLOGY AND FORMS IS AT THE USER'S RISK AND CARRIES NO IMPLIED GUARANTEE OF ACCURACY. USERS OF THIS METHODOLOGY AND THESE FORMS ARE ADVISED TO SEEK PROFESSIONAL ASSISTANCE IN DETERMINING THE ELECTRICAL CAPACITY OF A SERVICE PANEL. ------------------------ - Page 3 of 5 --- --_ - --- --