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15110201�1 kk CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS.- `22324 CARTA BLANCA ST CONTRACTOR: WILLOW GLEN PERMIT NO: 15110201 ELECTRIC INC OWNER'S NAME:i; STEiN�,LAWRENCE M TRUSTEE & ET AL 1085 WARREN AVE DATE ISSUED: 11/30/2015 OWNER'S PHOND;:'�'4089968158 SAN JOSE, CA 95125 PHONE NO: (408)289-9725 ❑ ;, I; ".'DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ,;`,'! . .'LICENSED.CONTRACTOR'S r ;• _ INSTALL (N) TESLA CAR CHARGER IN GARAGE WITH ,icense Class C ! Lic. # <5 �I' DEDICATED CIRCUIT Contractor te I her1.eby affirm that.I am licensed under the provisions of Chapter 9 (commeuSin' ' , , :•Seetion'7000) of Division 3 of the Business & Professions '-e Code"and'that mY. -Ii " - isin full force and effect. I hereby affirm ander penalty of perjury one of the following two declarations: nd will;maimain.a certificate of consent to self -insure for Worker's I have and' Compensation,' as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $1990 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 APN Number: 32613043.00 Occupancy Type: permit is i§sued.';',.:; : - . 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 con'stcuction; and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnifyjand keep�6mless the City of Cupertino against liabilities, judgments, costs and expenses which may accrue against said City in consequence of the Issued by: Date: granting of this permit. 'Additionally,Ihe applicant understands and will comply _,��,­?n/ with all non -point, source regulations per the Cupertino Municipal Code, Section 9.18. iSignature ;h%1%� % Date O_�� RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is )I °` installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER' DECLARATION Signature of Applicant: Date: I herekin"that I am exempt from the Contractor's License Law for one of the following two reasons: ' I ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as ownei:of the property,' or,my employees with wages as their sole compensation, will do the work, and,the structuie is not intended or offered for sale (Sec.7044, Business & Profe`ssio'ns Code) ' I, as owner of the ,property,' an 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. I will I her6y'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 the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 255(15 25533, and 25534. Section 3700 of the, Labor C�ode,. for the performance of the work for which this �. permit is issued.; !, +? caner or authorized agent: / Dater �C✓ I certify that in the performance of the work for which this permit is issued, I shall not employ anyperSon in any•manner so as to become subject to the Worker's Compensation laws of�Califomia..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 Lender's Address 4 APPLICANT CERTIFICATION I certify that I have iead.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 S ignature i : • 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 • buildinca(c)-cucJertino.org/ AE PROJECT ADDRESS �w w f . APN # � r r OWNER NAME /� E� ,,A /6 STREET ADDRESS n� -3 /� %� B ` lJ� .CITY, STATE, ZI • ;_c FAX CONTACT NAME Matt Londdrf e PHONE (408) 705-3663 E-MAIL matt@willowglenelectric.com STREET ADDRESS PO Box 8430 CITY, STATE, ZIP San Jose CA 95155 7 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Mark Londre LICENSE NUMBER 591918 LICENSE TYPE C1 Q BUS. LIC # 15897 COMPANY NAME Willow Glen Electric, Inc. E-MAIL info@wiIlowglenelectric.com J FAX 'jcs-,gocl _,:�7z. STREET ADDRESS PO Box 8430 CITY, STATE, ZIP San Jose CA 95155 PHONE (408) 289.., 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 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: NUMBER OF PANELSlUNITS: KILOWATTS (COMMERCIAL ONLY): L VALUATION: /1 DESCRIPTION OF WORK Cl 1 N �ECEI BY: By my signature below, I certify to each of the following: application and the information I have provided is correct. ordinances and state laws relating to building const c to . Signature of Applicant/Agent: u'i �� I am the property owner or authorized agent to act on the property owner's behalf. I have read this I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local a�/ ori a r7ep� entatives of Cupertino to enter the above -identified property for inspection purposes. / /�Crr"' Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W OVER-THE-COUNTER w E" x ❑ EXPRESS U W x ❑ STANDARD U LARGE a 1-1 =MAJOR PVApp 2011.doc revised 03116111 CITY OF CUPERTINO FF.F, ESTIMATOR — BUILDING DIVISION fe �� ii`ll;� �I t �k QIP' S17 t',r Plan ('heek 0iher l't,rmb Insp. Plumb. 171-sp. Fee: 117ec. pe,i rail Fee: 0. rtes blee. kq). h;rec.lns):.Fee: lvujE.. ift estimate does not inctuae fees aue to outer Departments (Le. rianning, ruottc works, rtre, aantrary J'ewer District, acnool District, etc:)! ! `The's'e ees are. based on the prefinidina information available and are only an estimate. Contact the De t or addn'l info. ADDRESS: 22324 CARTA BLANCA ST DATE: 11/30/2015 REVIEWED BY: MELISSA MISC ITEMS APN: '':326 13 043 BP#: "EVALUATION: 1$1,990 *PERMIT •TYPE: !' ;- Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY- SFD or Duplex USE: PME!Plan, Check: ' . PENTAMATION SOLAR -RES PERMIT TYPE: WORK.' 'INSTALL N TESLA CAR CHARGER IN GARAGE WITH DEDICATED CIRCUIT SCOPE 1: Suppl. Insp. F,ee.,!;1, ;, ;Reg:I : 0 OT fe �� ii`ll;� �I t �k QIP' S17 t',r Plan ('heek 0iher l't,rmb Insp. Plumb. 171-sp. Fee: 117ec. pe,i rail Fee: 0. rtes blee. kq). h;rec.lns):.Fee: lvujE.. ift estimate does not inctuae fees aue to outer Departments (Le. rianning, ruottc works, rtre, aantrary J'ewer District, acnool District, etc:)! ! `The's'e ees are. based on the prefinidina information available and are only an estimate. Contact the De t or addn'l info. FEF1 ITEMS (Fee Resolution 11-0.53 E . 7/1/13) FEE QTY/FEE MISC ITEMS Pla'n'Check 'Fee;.:?: $0.00 1 # Alternative Energy System $109.00 ICHRGSTA EV Charging Station .; S;uppl. PGFee.,' Reg.. OT 0.0 hrs $0.00 PME!Plan, Check: ' . $0.00 ' ' Permit Fee111 $0.00 1: Suppl. Insp. F,ee.,!;1, ;, ;Reg:I : 0 OT Q. Q hrs $0.00 PWUnit,Fee: $0.00 PME�Permit Fee: ` $0.00 1dn2in4`i '%;Ladd,.' +ee,.,' . 0 Work Without Permit? 0 Yes •; No $0.00 Advanced -Planning Vee:' $0.00 Select a Non -Residential E) Building or Structure 0 "YX1'd'�/-�;.�f�(>?,tili£'71IfX%T()i2• l'f,'�.',5:. Strong lVlotion'Fee::° IBSEISMICR $0.50 Select an Administrative Item B1d ,Stds Commissidn Fee: IBCBSC $1.00 SUBTOTALS $1.50 $109.00 TOTAL FEE: $110.50 `� Revised: 10/01/2015 Install one 240V 30A dedicated circuit with a new NEMA 10-30 receptacle on the left interior wall of the garage for EV charging. The circuit will be ran in 6/3 Romex through the crawl space from the existing main 125A electrical panel located on the left side of the home. OFFICE COPY GARAGE DOOR Larry Stein 22324 Carta Blanca Street Cupertino, CA 95014 (408) 966-8158 00, iob�Ssef, S/ ® or c461 s/0 t ca 0/aa '9�0 `� f Th %o -S'-0 f?"7,0 oa�� '7t. oc�f°afO�C� qy n vtip 7 Orj Po f ap 7S yAro th/S Plo 0,2 S iS 4h 4A froe o t`, be i ob spec/ thee�%a atoalot atth� 4,- CHECKED ,_ CHECKED BY CUPERTINO RECEIVED Residential Electrical Load Calculation Site Location: Prepared by I L LO W Larry Stein Willow Glen Electric, Inc. L E N 22324 Carta Blanca Street PO Box 8430 L E C T R 1 C Cupertino, CA 95014 San Jose, CA 95155 (408)966-8158 (408)289 -9725 -office General Lighting and Receptacle Loads [220.12] 3 watts per ft' x 2,423 = 7,269 Small -Appliance Branch Circuits [220.52(A), 210.1(0)(1)] 1,500 watts x 2 = 3,000 Laundry Branch Circuit(s) [220.52(8), [210.11(0)(2)] 1,500 watts x 1 = 1,500 11,769 Fastened -In -Place Appliances [220.53] Kitchen Bath(s) Outisde/Miscellaneous Refrigerator(s) = 960 Instant Hot H20(s) = Exhaust Fan(s) = Hot Tub = Dishwasher(s) = 960 Hood Exhaust(s) = Jacuzzi Tub(s) = Pool Equipment = Garbage Disposal(s) = 600 Gas Range(s) = Radiant Heating = H2O Pump = Microwave(s) = Gas Oven(s) = Steam Shower = H2O Pump = Trash Compactor = Wine Fridge(s) = = Elevator = _ _ = 30A Circuit = Total Fastened -in-place Appliance Load 2,520 F Clothes Dryer(s) [220.54] 80% x 240 x Derating Volts Amps 720 OR Name Plate Rating of Clothes Dryer = 720 Ranges, Ovens, Cooktops, and Other Household Cooking Appliances [220.55] 800A x 24 x 40 = 7,680 Derating Volts Amps AND/OR Name Plate Rating of Cooking Appliances = Heating or Air -Conditioning System (Compare the heat and A/C, and omit the smaller.) [220.60] Air Handler/Furnace 115 x 6.0 - Volts Amps Air Conditioning Unit 8,610 55% x 240 x 60 = Derating Volts Amps AND/OR Name Plate Rating of Air Handler & AC Units = Total Volt -Ampere Demand Load [220.83] Greater of.. Air-conditioning Equipment 8,610 x 100% = 8,610 Electric Space Heating - x 100% = First 8kVA of all other loads 8,000 x 100% = 8,000 Remainder of all other loads 14,689 x 40% = 5,876 22,486 Total Current Minimum Amperes 22,496 - 240 - 93.7 17 Current Minimum Size Service or 125 Amps (voltage) (minimum amperes) Feeder [240.6(A)] Currently Electric Vehicle [625.14] 125% x 240 x 24 = JU(i Continuous Load Volts Amps Minimum Amperes with Added Load Minimum Size Divide the total 29,686-- 240 = 123.7 20 Service or Feeder 125 Amps volt-amperes by (voltage) (minimum amperes) w/ Added Load with added load the voltage. [240.6(A)] NOTES CUPERTINO All References are to 2014 National Electrics e. q uildina Department _ NOV 3 0 2015 REVIEWED FOR CLUE COMPLIANCE Revlewea By. Need help finding a qualified electrician, or have questiotT about home charging installation? Contact Tesla at: Charging Installation esl : 'tatgryseom or 1-877-798-3752 2i m C CO r � INSTALLING YOUR 240 VOLT OUTLET Every Model S includes the Mobile Connector, which is a 20 -foot long cable with a set 11'j m o of adapters for standard electrical outlets. The NEMA 14-50 adapter ensures the best charging experience with the Mobile Connector. Tesla recommends installing a 240 Volt outlet with a NEMA 14-50 receptacle where you plan to park your vehicle. This is a common outlet, often used for home appliances, and the electrician you hire for the installation will provide all necessary materials. You can charge your Model S from this outlet at a rate of 29 miles per hour. Below you will find all relevant information required for an electrician to complete the installation. Note: municipal building departments frequently require a permit and inspection for any electrical modifications in your home. Any licensed electrician will be able to take care of this paperwork and provide a copy for your records. DETAILS • Voltage: Single phase, 208-250 Volt AC supply, 60 Hertz • Current: 50 Amp circuit breaker / 40 Amp continuous current • Wiring Recommendation: 6 American Wire Gauge, copper conductors only • Ground Fault Circuit Interrupter: Not required • Service Disconnect: Not required • Receptacle Recommendation: High quality, industrial grade receptacle • Location: Install near vehicle charge port, maximum 15 feet away. Minimum 18 inches above ground. • Electric Code Compliance: Installing electrician will source permit and inspection as required by local municipal building department RECOMMENDED OUTLET LOCATIONS ONE OR TWO VEHICLE GARAGE ' w ............ CHARGE PORT OUTLETS FOR YOUR RECORDS ELECTRICAL COMPANY PHONE NUMBER EMAIL ADDRESS PERMIT NUMBER INSTALLATION DATE T = 5 L n 3500 Deer Creek, Palo Alto, CA 94304 1 Nov. 2014 1 Version 1.0