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15040177-PUB7738 OAK MEADOW CT 15040177 SOHINI RAJPAL SCANNED BOX #585 CITY OF CUPERTINO BUILDING PERMIT BI ULDING ADDRESS: 7738 OAK MEADOW CT I CONTRACTOR: '�D�� G� PERMIT NO: 15040177 OWNER'S NAME: SOHINI RAJPAL 3 `f� jl/N/�/�� 2VV DATE ISSUED: 04/23/2015 OWNER'S PHONE: 9166319293 �y�/G f CG �R L R PHONE NO- 1&t l 3 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL INSTALLATION OF ROOF MOUNTED SOLAR (16 License Class �`Lic. # -561 MODULES) Contractor �Qrr-dz (i to Date lZ3' 1 (5.23KW) 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: 1 have and will maintain a certificate of consent to self -insure for Worker's Co pensation, as provided for by Section 3700 of the Labor Code, for the M ance of the work for which this permit is issued. dwill 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. APPLICANT CERTIFICATION certify that 1 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionall the applicant understands and will comply with all non -point source regulat' per the Cupertino Municipal Code, Section 9.18. Signature I Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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, costs, and expenses which may accrue against said City in consequence of the 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. Sq. Ft Floor Area: I Valuation: $27000 APN Number: 36626010.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: /G Date: 3 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Aippuality Management District I will maintain compliance with the Cupertino Wnicipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505,2W4 and 25534. Owner or authorized agent: Date: c1 _-ZS —I CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional Signature Date l5oyoi77 CUPERTONO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (408) 777-3228 a FAX (408) 777-3333 o build ingCcDcupertino.org AE PROJECT ADDRESS O ` ` APN # OWNER NAME e ► -A �� STREET ADDRESS T7> � �� N C�J�i! GI PHONE 916 6 � _ SZ�� E-MAIL CITY, STACK I � /� �0` O I FAX CONTACT NAME , 6 �l 6l!` PHO 17, � �� -bbco STREET ADDRESS03j 1 L okaL N 6 CU,�Xj Ip FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR t_<O�RACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMB LICENSEE 6 BUS. LIC # COMPANY NAME -X. Iw`� E-MAIL �d F �) STREET ADDRESS 3 5L> u � n l ' � W� (p,—",' C TY. ST L F� -` P �� y ^ A �CJ' 7' 1 ` is `1 b ARCHITECT/ENGINEER NAME LICENSE NUMBER( BUSS. UC H COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes Q—NO PROJECT IN FLOOD ZONE ❑ Yes _Q—No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION El SOLAR WATER HEATING El OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: Z� W DESCRIPTION OF WORK i/ G 46 7- i x RECEIVED By By my signature below, I certify to each of the following: I am the operiy owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I hav ad the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bull ' struction. I a rize representatives ertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPL MENTAL ORMATION REQUIRED q OFFICE USE ONLY w" VER-7 HIkOUNTER ` .EXPRESS U .. x..ra . STANDARD' •^o; t ;-: U a❑ a LARGE `❑ MAJOR P VApp_201 1. doc revised 03116111 J"TTt7 /lT /1TT""T7"TT1LTl1 g[ADDRESS: \..11 1 Vl' %_%jX l:L_L1V1111%V FEE ESTIMATOR — BUILDING DIVISION 7738 OAK MEADOW CT DATE: 04/23/2015 REVIEWED BY: SEAN PN: BP#: 'VALUATION: 1$27,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair ]PRIMARY SFD or Duplex USE: PENTAMATION SOLAR-RES I PERMIT TYPE: WORK INSTALLATION OF ROOF MOUNTED SOLAR 16 MODULES 5.23k SCOPE titech. Plan Check P/runh. I'furr (:'hrcF Islec. Plan Check ;L1ech. Pernril Fee: Plumb. Permit Fee: Elec. Permir Pee- Orher Alech. Insp.F-1 Other Plumb Insp.Li Other E/ec. Insp. Alech. hrsp. Fee: Plumb. hrsp. Ilee: Elec. hasp. 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 nreliminarv, information available and are only an estimate.' Contact the Dent for addn'l info. IEEE ITEMS (Fee Resolution 11-053 E f' 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $236.00 Alternative Energy System IpHoTovREs Photovoltaic System Suppl. PC Fee: (F) Reg. 0 OT p.p hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Kix. Acirninistrative Fee: 0 E) Work Without Permit? Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 19 Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $3.51 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $5.511 $236.00 TOTAL FEE: 1 $241.51 Revised: 04/01/2015 37/- --�! Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LET JOB ADDRESS: ` 71 t- Av 4 PERMIT # 0 177 OWNER'S NAME: 0-0J Dom-- PHONE # 10 6 31 -'9Z; 3 GENERAL CONTRACTOR: Sot-McA) BUSINESS LICENSE # ADDRESS: �� °U Sv&441,e {5wtj CITY/ZIPCODE: qqf) UAWjA-Ca- 1 *Our nnunicipap come requires all➢ businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR (FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACT S HAVE OBTAINED A CITY OF CUPIERTINO BUSINESS LICENSE. P � I am not using any subcontractors: Signature Date ?E ease check applicaWe subcontractors and complete the ffoHowing information: V SUBCONTRACTOR BUSffN ESS NAME BUSffN ESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature IDate