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15060010CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7625 ERIN WAY CONTRACTOR: SOLARCITY PERMIT NO: 15060010 OWNER'S NAME: JOSEPH LEE 3055 CLEARVIEW WAY DATE ISSUED: 06/02/2015 OWNER'S PHONE: 4082552636 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL INSTALL 30 ROOF TOP, LUSH MOUNTED PV MODULES License Class C_ ^ JQ , (a Q Lic. 8 q (7.8KW). UPGRADE (E) EL PANEL TO 200 AMPS, SAME Contractor � t � Date (j ti &Z1 )S LOCATION 1 hereby affirm that 1 am license 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 Sq. Ft Floor Area: Valuation: $16000 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 APN Number: 35920019.00 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 DA $�9F– T ANCE 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 1A M L NSPECTION. $0 D indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Z granting of this permit. Additi ally, applicant understands and will comply Date: with all non-point source reg tion r the Cupertino Municipal Code, Section 9.18, Signature Date Cr 9 RE-ROOFS: prior to any roofing material being installed. If a roof is All roofs shall be i;tob4t'aining installed without ti an inspection, I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of 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). 1 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 o 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 lity Management District 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino. u i pal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 3 nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 62 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 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. Additional the a plicant understands and will comply with all non-point source regulat' ns pe pit e Cupertino Municipal Code, Section Licensed Professional 9.18. Signature — Date Q(, vii r CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-1255 (408) -777-3228 • RAN (4+08) 777-3333 • b0dinq(acupeltino.orq � � 0 � D O � O PROJECT ADDRESS f� C � & APN N ' 04U VER NAMEC»E-MAIL STREET ADDRESS TTY, CTATE,iZIIP , FAX p n l CONTACT NAMPMarjan Javanmard PH0N`E650.477.6430 E-"IA`En-ljavanmard@solarcity.com STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OW'N'ER AGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT ❑ ARCIETECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMESOIarCity Corporation LICENSE NUIV[BER 888104 LICENSE TYPE C10 BUS LTC g28840 COMPANY NAMESOIarClty Corporation E-11Lmjavanmard@solarcity.com FAX STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PH0'650.477.6430 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC N COMPANY NAiME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRU TURF ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO SOLAR PANELS T-OIIECTRJC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUIVIBER OF PANELS/UMTS: 30 KILOWATTS (COMMERCIAL ONLY) , TOTAL VALUATION DESCRIPTION OF WORK Installation (30 ) rooftop flush mounted solar panel kW ere -Ax- BY By my signature below, I certify to each of the following: lam pro owner or authorized agent to ac I have read this application and the information I have provided is correct. I ha ea Description of Work and ver It is a e I agree y with all applicable local 're ordinances and state laws relating to building construction. I tr' resentatives of Cupertino to enter the above-ide rnperty for inspection purposes. Signature of Applicant/Agent: Date:�,� SUPPLE AL NIFORMATIOT 0IFFICF USE ONLY sz vERTAF COI.INTFR ❑ >ra1>Rlcss © STANDARD u El 'LAIRGF z ❑ "MAJOR PVApp_2011.doc revised 03116111 CITY OF CUPERTINO RM -1 FEE ESTIMATOR - BUILDING DIVISION NOTE; This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nictrict etc L These fees are hared on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef 7/1113) FEE /'fw w'� 1 l ;, ( i,), Elec. Plan; Check 0.0hrs $0.00 ADDRESS: 7625 ERIN WAY DATE: 06/02/2015 REVIEWED BY: MELISSA Alternative Energy System IPHOTOVRES Photovoltaic System AN: 359 20 019 BP!:_ 00,16 'VALUATION: j$166,000 Pln)�h cc hrs t10 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex Electrical IBELEC200 Services PENTAMATION SOLAR -RES USE: $0.00 PERMIT TYPE: WORK I INSTALL 30 ROOF TOP LUSH MOUNTED PV MODULES (7.&M. UPGRADE E EL PANEL TO SCOPE 1200 AMPS, SAME LOCATION NOTE; This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nictrict etc L These fees are hared on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef 7/1113) FEE /'fw w'� 1 l ;, ( i,), Elec. Plan; Check 0.0hrs $0.00 Plan Check Fee: Elec. Permit Fee: IEPERMIT L__Ljl # $236.00 Alternative Energy System IPHOTOVRES Photovoltaic System Other Elec. Insp. hrs $48.00 0.0 Suppl. PC Fee: (F) Reg. Q OT0.0 Pln)�h cc hrs NOTE; This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nictrict etc L These fees are hared on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 L__Ljl # $236.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: (F) Reg. Q OT0.0 hrs $0.00 PME Plan Check: $0.00 200 1 amps $48.00 Electrical IBELEC200 Services Permit Fee: $0.00 Suppl. Insp. Fee.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 Administrative Fee: 1ADMIN $45.00 0 Work Without Permit? O Yes E) No $0.00 Advanced Planning, Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $2.08 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $144.08 $284.00 TOTAL, FEE: $428.08 Revised: 05/07/2015 PA -20 m x 5 ag z W e t- a W� o 1►1 F' H Seo o O o N W x u►d w ��W U•? r- O U �� N J� U � O Q q Q W o V cr , z m rcG -� w N o yo o� u cL W orLJJ to z Cos CL Q ¢ ei D I-- C 3 h Tv @0 o m z _msB'VZ �J W m Y d Q J O R 0 Q mp 'Q s E o c cnrn -T,m T L �QQi LU LL v' ,.n • ■W � U Q F- 2: W [� H 4 Ahl1�Yi��l'��I I LLI ZO_ c E E o ~ Z fll �Y Ld > (n O O� w �o ro W V e W07 O O w � O = e wuO O ,II y I Z 1 d Ln H q m 1 � v O 6 cc IZ < q U Z � U clj Z YW m p 'y7 LTJ Q � Y vi c~io m o ¢o m �� bi Ljtoo� W W N m Wo z oow 5wzzt- �z� dz O W � woo O- .2t —o m qO W Q ��� dU Z �Z�O a W z UmO� �0�� 00� UYC7 z: � OO J�UU Sm�o OX mm0 Gz J zz<Nw oo zw on�of o z v Z mZ JM]yZ3 0�}�1- N W W'd <d_m Jtr V 000¢0¢0 hU� ¢> ri S �H CCW 0 S S O W U 4= :26- V l ::Ed W O Z Z U J Z �¢� 1"�o z YooUO� O U W W W=w W J W m (L'N Z•3¢ �O =� /n 'Sm� W ZCaj Q ¢ O J�� `1 WN p= Z O z zWz n d 4 U O d Z O W H 4 J 3 N Z W W U Y 0 Z O Z¢ w N 1¢i_ J O 4 ZU¢ f='tn m 0 J 0 W Z =0 O ww N 0 J d U U J I Z Cc Z W W 1 r{ Q W d S O Z N W J ,¢ a p 0 a¢ S Z LC) N ( n U N t••') J U eY <` d S 16 tl (O m W 00 � O Qi S m U U cV 1- H W U-) U p CEJ N N O M O Lu � M OO U N W O E 3 F O O,.�m W cn C7 ~ 0 N 3 W W OU ri m Z W O N 3w? a 1"1 w z U o z O [Y J z o OU ,- W I �O w 'k' g_ 14' .0uj < oW�w ' F-Sa dU4 U� f-UmU�Eiws'aF�� (n D << D m WZZ WUw o�wzoma zz`�-,�m� aozao�mWa-ice �� ren o c a8a'n'�a Q[ems �,-'� Z�u1 .� ZZo W W HO`s 0 W w�00-�0¢�`-' a ¢ w ocJUmt= >m= �cc�>30� 1- Ua 1-wzzc.� 1 -HI- ¢ `w P8i'B ��o�ox��a��o»=000Zwwoz�o�S��iz000aw o a dd mU0 W W W ti f.�UC.?S V V (l1YYJg ZZZOd dd(n f.!)(n 1-�»> ^si Z U y Z�o�J OF o ��Sa oz U 1-m�Uoca n a 3z.-,�cn = U u� o.0 o .. 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