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15080210CITY OF CUPERTINO BUILDING PERMIT i BUILDING ADDRESS: 10381 ORANGE AVE I CONTRACTOR: SOLARCITY I PERMIT NO: 15080210 I OWNER'S NAME: JOANNA WANG 1 3055 CLEARVIEW WAY 1 DATE ISSUED: 08/28/2015 1 OWNER'S PHONE: 4082527664 LICENSED CONTRACTOR'S DECLARATION License Class G0 j C,W Lic. # ]Y E $ 10 14 Contractor A &,2 (CA fr,an. Date ff .1A_ V _S 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 ma ccrue ainst said City in consequence of the granting of this permit. Addi nail a applicant understands and will comply with all non -point source re latio er the Cupertino Municipal Code, Section 9.18. Yn Date 15 ❑ 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) 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 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. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date SAN MATEO, CA 94402 I PHONE NO: (650) 638 -1028 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALLATION OF ROOF MOUNTED SOLAR SYSTEM (42 PANELS)(10.92 KW). Sq. Ft Floor Area: I Valuation: $24000 APN Number: 35714055.00 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: Z7j-A7l'A% Date: gi RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, l 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. 1 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 A?,J ality Management District I will maintain compliance with the Cuperti Mpal Code, Chapter 9.12 and the Health & Safety Code, Sections 255053 d 25534. Owner or authorized agent: Dater 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 ALTERNATIVE ENERGY PERMIT APPUCATION GCDP0MUNITY DEVELOPMENT DEPARTMENT a BUIDING MAMN `¢MTORRE AVENUE • CUPERTINO, (;A 950D4- ,255 AE (4 08) 7777-5228 • FAX (406) 777-338:9 - buBlldin,aiing.. /IV6(5�1z� PROJECT ADDRESS I D 1 j1 r &,n , —Ave_ APN # OWNER NAME �/] iC1„ ak-,:.A �jo,Y, PHONE � 664 E -MAIL STREET ADDRESS`" �l� g F t /T,,�,Cl� �]; r� [vJ �j l/ ��+ CITY, STATE, ZIP },no j Gflii C15 01 FAX CONTACT NAME Nlarjan Javanmard PFI°NE650.477.6430 E-MAIL mjavanmard @solarcity.com STREETADDREss391 Foster City Blvd CITY, STATE, "'Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BMDER ❑ OWNER AGENT ❑ CONTRACTOR ❑a CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORHAMESOIarClty Corporation LICENSE NUMBER 888104 LICENSE TYPE C10 BUS. LIC #28840 COMPANY NAME SolarCity Corporation E-MArLmjavanmard @solarcity.com FAX STREETADDRESS391 Foster City Blvd CITY, STATE, ZIPFoster City, CA 94404 PHONE 650.477,6430 ARCHITECT/ENGNEER NAME LICENSE NUMBER BUS. LIC k COMMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Dup]ex ❑ Multi - Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT IN FLOOD ZONE ❑ Yes ❑ No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. N1UiviBEROFPANELS/UMTS: "1 KILOWATTS(COMMERCIALONLY): to p/� (( ll TOTALVAL ATION DESCRIPTION OF WORK Installation (u ) rooftop flush mounted solar panel kW RECEIVED BY: Ei �W By my signature below, I certify to each of the following: I aI the pr 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 ve rea e Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction, t o e r resentatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEME T INFORMATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER ❑ EXPRESS V U V ❑ STANDARD LOILARGE AJOR PVApp_2011.doc revised 03116111 .�irrrn�cr .r'i.rn .err rrrnmrm rtmr�r.n. i 11,1111 R 4lD'iP Fl [U SC1P�11R ll ll1V �SJI FEE ESTIMATOR - BUILDING MVESRON ADDRESS: 10381 ORANGE AV E DAVE: 08/28/2015 REVIEWED BY: SEAN 1161111b. Plarr Chcck APN: BP #: 5OO 0,7 v -VALUATION: 1$24,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: other Elec. Insp. P]ENTAMATION SOLAR -RES PERMIT TYPE: WORD INSTALLATION OF ROOF MOUNTED SOLAR SYSTEM 42 PAI\IELS 10.92 SCOPE Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. OT 0.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.'onsf'ruction Tax: Administrative Fee: 0 Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure d Travel Documentation Bees: Strong Motion Fee: IBSEISMICR $3.12 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $4.12 $236.00 TOTAL FEE: $240.12 i 1Ltech, Plan Check 1161111b. Plarr Chcck Elec. Plan Check atr>c;h, Permit free: Plumh. Permit/ Fire: /slec. Permit Fee: Other Aloch. I11sp. Other Plumb 7nsp. other Elec. Insp. tlectl. lmp. Fee: Fhculi, h1sp. Fee: bloc. Ittsp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, (Fire, Sanitary Sewer District, School District.'etc.). These fees are based on the preliminary information available and are onlv an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Eff 711113] FEE QTY/FEE Ml[SC ITEMS Plan Check Fee: $0.00 0 # Alternative Energy System $236.00 /PAOTOVRES Photovoltaic System Suppl. PC Fee: 0 Reg. OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. OT 0.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.'onsf'ruction Tax: Administrative Fee: 0 Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure d Travel Documentation Bees: Strong Motion Fee: IBSEISMICR $3.12 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $4.12 $236.00 TOTAL FEE: $240.12 Revised: 0710212015 LM Address SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildino(cDcuoertino.org PURPOSE This affidavit is a self- certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single- family and multi - family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of 'additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Secti ons 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon. Monoxide Alarms be installed in the following locations: AREA I I SMOKE ALARM CO ALARM Outside of each separate sleeping area in! the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room I X Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no comrnercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As Owner of the above- referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. i have read and agree to comply v✓ith the terms and gonditions of this statement (or Owner Agent' .. ...'.,Y—J.......A....... ..... t..... .. ............................... Date: re...... ............................................................. Lic.TM ....... ............................... Date: ................. Smoke and CO jbi -ndoc revised 03118114 CUPERTIVV' O Owner Name Address O�rti'IJE� CETIFIC.aTE OF COMP IA CE COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014 -3255 -3333 ^ building(&cupertino.org Permit No. 1 HIM 1p 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. [ No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water - conserving plumbing fixtures is not technically feasible? E-1 Yes Civil Code Sections 1101.1 through',1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. /NO Go to Question 3. 3. Is water service permanently disconnected for your building? Ve s Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0 Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. C/Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. PI se check ONE of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non - compliant plumbing fixtures to be replaced with water- conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water' - conserving plumbing fixtures. On or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water- conserving plumbing fixtures. On or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non - compliant plumbing fixtures will be replaced prior to date specified above with water - conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water- conserving plumbing fl Lures comply with the requirements as indicated in the table on the following pane. n r - 1\ . 11 \' n (N "') / ,/ Owner or Owner Agent's Signature: 1 1/ 1 , ' ., a ( _ b==V Date: U /,�iil UA --er- rt r, , Upon completing and signing this Certific te; ea e retu to the Buil 'ision i o ,,pder to final your building p rmit. 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