15050157-PUB10029 OAKLEAF Pl.
15050157
F/P
JOSEPH M AND LINDA S WEISS
TRUSTEE
SCANNED BOX #596
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10029 OAKLEAF PL I CONTRACTOR: CINNAMON SOLAR INC I PERMIT NO: 15050157 1
OWNER'S NAME: JOSEPH M AND LINDA S WEISS TRUSTEE 1 1550 DELL AVE STE K I DATE ISSUED: 05/29/2015 1
OWNER'S PHONE: 4082536878 1 CAMPBELL, CA 95008 1 PHONE NO: (408) 883-7000 1
❑ LICENSED CONTRACTOR'S DECL%ARATION
License ClassC _'IV, Lic. N C tU
Contractor( 1AJMtA4W�Sip [4V Date 612,4
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
performance of the work for which this permit is issued.
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
permit is issued.
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_-
Signature 6-6waia�
Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
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.
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
INSTALL 28 ROOF TOP, FLUSH MOUNTED PV MODULES
(7.OKW) & INSTALL (N) SUB PANEL (100AMP) IN SIDE
YARD AREA
Sq. Ft Floor Area: I Valuation: $23700
APN Number: 32618056.00 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: 5�aI V A4Date -�
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
I 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 I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sectio 25505, 25533, and 25534.
Owner or authorized agent:6'"W—watc: L
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 Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
Signature Date
CUPERTINO
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 SCE S67
PROJECT ADDRESS I no q
APN # 905
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❑ OWNER ❑ OWNER -BUILDER
❑ OWNER AGENT
93 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHFMCT ENGINEER ❑ DEVELOPER ❑TENANT
CO RACTOR NAM
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NA
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LICENSE NUMBER
BUS LIC #
COMPANY NAME
E-MAIL
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STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex
❑ Multi -Family
PROJECT IN WILDLAND
PROJECT IN
STRUCTURE ❑ Commercial
URBAN INTERFACE AREA ❑ Yes [A_<0
FLOOD ZONE ❑ Yes [9 No
LY SOLAR PANELS T-CIELECTRIC
VEHICLE CHARGING STATION
❑ SOLAR WATER HEATING
❑ OTHER: _
FOR SOLAR PANELS: NUMBER OF PANELSUNITS 2
KILOWATTS (COMMERCIAL ONLY):
TOTAL VALUATION:
DESCRIPTION OF WORK
Vim,
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By my signature below, I certify to each of the following
I am the property 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 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to
i 'Onstruction.
I thori presentatives of Cupertino to enter the above i entified p operty for inspection purposes.
Signature of Applicant/Agent:
Date;
SUPPLENaNTAL INFORMATION REQUIRED
OFFIICE USE: ONLY
W
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PVApp_2011.doe revised 03116111
CITY OF CUPERTINO
IM-7, FEE ESTIMATOR — BUILDING DIVISION
LEIADDRESS:
10029 OAKLEAF PL
DATE: 06/26/2016
REVIEWED BY: MELISSA
APN: 326 18 056
BP#: )�
*VALUATION: $23,700
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION SOLAR-RES
PERMIT TYPE:
WORK
INSTALL 28 ROOF TOP FLUSH MOUNTED PV MODULES 7.Ok & INSTALL N SUB PANEL
SCOPE
(100AMP) IN SIDE YARD AREA
h : r ;AO". /,c,,r
,;;;
Elec. Plan Check 0.0 hrs $0.00
Elec. Permit Fee: /EPERMIT
Other Elec. Insp. 0.0 hrs $48.00
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 prelimina information available and are only an estimate. Contact the De t or addn'1 in o.
FEE ITEMS (Fee Resolution 11-053 Efl.711/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
= #
$236.00
Alternative Energy System
/PHOTOVRES Photovoltaic System
Suppl. PC Fee: Q Reg. Q OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
100 1 amps
$48.00
Electrical
1BELEC200 Services
Permit Fee:
$0.00
Suppl. Insp. Fee:E) Reg. Q OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
( ") T" P ,I?",,, ; 1 1, ! '1'.' ,
T7
Administrative Fee: IADMIN
$45.00
0
E)
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Plannin& Fee:
$0.00
Select a Non -Residential
Building or Structure
i
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICR
$3.08
Select an Administrative Item
Bldg Stds Commission Fee: /BCBSC
$1.00
SUBTOTALS:
$145.08
$284.00
TOTAL FEE:
1 $429.08
Revised: 05/07/2015