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15120018�CITE' OF CJPERTINO BUILDING PERMIT I [BUILDING ADDRESS: 10645 BAXTER AVE CONTRACTOR: SOLARCITY PERMIT NO: 15120018 OWNER'S NAME: LAU ALFRED C AND YIU WINNIE W OWNER'S PHONE: 4088584408 LICENSED CONTRACTOR'S DECLARATION License Class_ 10 � CSU Lie. Contractor Date 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. 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. 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 7�= he applicant understands and will comply with all nr the Cupertino Municipal Code, Section9.18. Signature Date UO3 / -5 171 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 (See.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. Sign Date 3055 CLEARVIEW WAY I DATE ISSUED: 12/03/2015 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0 INSTALL 20 ROOF TOP, FLUSH MOUNTED PV MODULES (5.2KW) & (N) 125 AMP PANEL Sq. Ft Floor Area: I Valuation: $11500 I APN Number: 32611012.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITIHN 180 DAB'S OF PN_RM 0 ISSUANCE OR 180 DAYS­FR(Y1-' LED INSPECTION. , ,y�0 � 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 )uati Management District I will maintain compliance with the Cupertino un�c► I Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, / ' d 25534. Owner or authorized agent: / { Date: 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 A ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION CONIM UNIT)' DEVELOHENT DEPARTMEN-1 . - BUILDING C_1IVISI0i,,I 10300 TORRE AVENUE - CUPERTINO. CA 950114-13255 (408) 71-7-3228 - FAX (408.) 777-333:2, - building cupertino,cra 0 PROJECT ADDRESS ve- -7 OWNER NAME PHONE .E-MAIL PH,01 qr-l� x STREET ADDRESS CITY, STATE, TE, C_ 0, NE CONTACT NAME Marjan Javanmard PHOI 650.477.6436 E-MAIL mjavanmard@solarcity.com STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 944041 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR X CONTRACTOR AGENT El ARCHITECT El ENGINEER 1:1 DEVELOPER 1:1 TENANT CONTRACTOR NAME SolarCity Corporation LICENSE NUMBER 888104 LICENSE TYPE C 10 1 BUS. LIC g28840 COMPANY NAME SolarCity Corporation E-MAIL mjavanmard@solarcity. COM FAX STREET ADDREss391 F - oster City Blvd CITY, STATE, Foster City, CA 94404 "0'650.477.6430 HIT T FARCMTEYCTI�ENIGINEER NAME LICENSE NUMBER BUS. LIC 9 COM COMPANY NAME M E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF [I SFDorDuplex 0 Multi -Family PROJECT IN WILDLAND PROJECT IN STRUPfURE: 0 Commercial URBAN INTERFACE AREA El Yes El No FLOOD ZONE Ej Yes 0 No SOLA:R:PA:NE�LSE] E�LECTPIC�VF-FMUCL�ECHARCrNGSTATION ❑ SOLAR WATER HEATING El OTHER: FOR SOLAR PANELS.- NUMBER OF PANELSIUNTTS:L, KILOWATTS (COMMERCIAL ONLY): TOTATATION: -_5 DESCRIPTION OF WORK Installation rooftop flush mounted solar panel I kW A DB By my signature below, I certify to each of the following: I am th jr'o'pert.y`#ner or authorized agent -to--a-cl-o-n-tfie-pro�perty owner's behalf. I have read this application and the information I have is I provided correct. have r7ad . the,p y it is accurate. I agree to comply with all applicable local ; Xcription of Work and verify ordinances and state laws relating to building construction. I aUthoriz6�r , fesentatives of Cupertino to enter the above -identified property�f r inspection nspection purposes. Signature ofApplicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER El EXPRESS U El STANDARD El LARGE El MAJOR P V4pp__:201 1. doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10645 BAXTER AVE DATE: 12/03/2015 REVIEWED BY: MELISSA SS. 10 P ADDRESS: 326711 012 BP#: *VALUATION: 1$11,500 *PERMIT TYPE: . Building Permit PLAN CHECK TYPE: Alteration / Repair PRIUSE: 1ARY SFD or Duplex PENTAMATION PERMIT TYPE: SOLAR -RES WORK INSTALL 20 ROOF TOP FLUSH -A SCOPE PANEL 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, etc.). These -fees are based on thepreliminar !ntormatlon available and are only an estimate. Contact the Dept,for addn'l info. FEE ITEMS (Fee Resolution 11-053 9ff 711173) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Alternative Energy System Suppl. PC Fee: (E) Reg. O=O:T�hrs $0.00 $236.001 IPHOTOVRES Photovoltaic System PME Plan Check: $0.00 125ampsElectrical Permit Fee: $0.00 $48.00 IBELEC200 Services Suppl. Insp. Fee: •.s Reg. C) OThrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00, 0 6 Select a Non -Residential E) Building or Structure 0 Administrative Fee: 1.4DMIN $45.00 Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Travel Documentation Fee: I TRA VDOC $48.00 Strom 0 , Motion Fee: IBSEISMICR $1.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS;: $143.50 $284.00­,�." -TQ T L' $427.50 Revised: 10/01/2015 CUPERTINO Owner Name WATER -CONSERVING PLUMBING FM`6 URES OWNER CERTIFICATE OF COMPUANCE COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 pp(4�08 777-3228 FAX (408) 777=3333 building(a cupertino.org Permit No Address ` i `U 64S:��1�' l ( . � Cr �( os At -(os c, qz� 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. if C]"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? ❑ 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. 2"'No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. jo eNo 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. 0"Yes My realproperty 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. Please check ONE of the following: C'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 irmprovements 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 fixtures comply with the requirements as indicated in the table on the following page.,..,, . .1� , I Owner or Owner Agent's Signatur'i�z'_ra Date,;�-s (ter f I S l 1 Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015.doe revised 08126115 SMOKE f CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE ' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION �P�6�1M1�46t7Qi 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 o FAX (408) 777-3333 • building(cDcupertino.org PEltNUT CANNOT DE FINALED AND COMPLETED UNTIL THIS CERTIFICATE 1gr15 L'I;1 QLff _ D .APv`D E-,�D.'1[ O ' ) , U,1.LD <1° Q D��J1sIO.N 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 Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM -A Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X =IL On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-bumirig 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 commercial 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 Califonda Residential Codes. The alarms have been tested and are operational, as of the date signed below. Smoke and CO form.doc revised 03118/14 w Of ao W a z� Q Z T pE- tY aJ W n U Z W 80o -S W s 7 q V FS Z O y w S Z¢? 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