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15120140B CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19911 LINDENBROOK LN CONTRACTOR: WILLOW GLEN PERMIT NO: 15120140 ELECTRIC INC OWNER'S NAME: MA HAN AND XIA YI 1085 WARREN AVE DATE ISSUED: 12/15/2015 OWNER'S PHONE: 6502437069 SAN JOSE, CA 95125 PHONE NO: (408)289-9725 H` LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL (N) 50 AMP DEDICATED CIRCUIT W/NEMA 14-50 r\ License Class V '1 Lic. # Sol `o h � RECEPTACLE IN GARAGE FOR TESLA CHARGER; Contractor \�6ate I Z INSTALL (N) 50 AMP CIRCUIT FOR OVEN IN KITCHEN; UPGRADE 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. Sq. Ft Floor Area: Valuation: $5763 ve 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: 36923019.00 Occupancy "I Npc 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 DAYS OF PERMIT ISSUANCE 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 180 WS FROM LAST CALLED INSPE TIO . indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the /"�`' ' Date: granting of this permit. Additionally, the applicant understands and will comply Issued by: with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. Signature / Date Z1 ) f, 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 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). I 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 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this s �Z Owner or authorized agent: Date: T 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 CONSTRUCTION LENDING AGENCY 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 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. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. 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 • buildin-g a�cupertino.org 151W40. AE PROJECT ADDRESS Q f �J/p APN # OWNER NAME /J �/ A I�` PHO E.SD �-ro6 E-MAIL 447rL STREET ADDRESS � / 1 1 WV,6`ZDO4 4 V1 L�� CITY, STATE, ZIP 'O CA rsw $ f FAX CONTACT NAME Mark Londre/!!L7 PHONE (4'0,8/))289-9725 E-MAIL office@willowqlenelectric.com STREET ADDRESS P. O. BOX 8430 CITY, STATE, ZIP San Jose, CA 95155 FAX(408)289-9725 1 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Mark Londre LICENSE NUMBER 591918 LICENSE TYPE C_10 1 BUS. LIC # 15897 COMPANY NAME Willow Glen Electric, Inc. E-MAIL office @willowglenelectric.COM FAX (408)289-9725 STREET ADDRESS P. O. Box 8430 CITY, STATE, ZIP San Jose, CA 95155 PHONE (408)289-9725 ARCHITECT/ENGINEER NAME NSA LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO ❑ SOLAR PANELS ><1 ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUA 5Tb�,. DESCRIPTION OF WORK Electric Vehicle Charging Circuit: �uc�w.il:/viol (i)�#o YAet.W0 iia.V L .Z �VP1640CIC4 !oo �4n�y .& t e t�� a ijb 1/d.Lt �rr� .1rdttot c:«e�cc 9 ,�� I/4�tA ��-so �ta� r,.; S�t� 7 T �(t a �caj a Qcsa !� -t 4,9 slat 3-0 *ow atedinZWoe ZuAccuy .45k- -ikl, - 0;1_v - - RECEIVED BY: 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 building construction.. I authorize, of Cupertino to enter the above -identified property for inspection purposes. 1C;2 —If S U Signature of Applicant/Agent: �} Date: SUPPLEMENTAL INFORMATION RE UIRED OFFICE USE ONLY w OVER-THE-COUNTER ❑ EXPRESS a F' Y U W S ❑ STANDARD U ❑ LARGE a ❑ MAJOR PVApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION im,ADDRESS: 19911 Lindenbrook Lane DATE: 12/15/2015 REVIEWED BY: PAUL Ale"::.:".rr' it�;> APN: 369 23 019 BP#: *VALUATION: 1$5,763 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex PME Plan Check: PENTAMATION PERMIT TYPE: SOLAR -RE i WORK Install N 50 Amp dedicated circuit w/Nema 14-50 receptacle in garage for Tesla Charger; Install N SCOPE 50 Amp Circuit for Oven in Kitchen; Upgrade (E) 100 Amp panel to (N) 200 Amp Panel NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nictrirf of,- ) Thece feoc are ha.Ced an the nreliminary information available and are only an estimate Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 &f. 7-1/13 3,cr;t. 1'J;irt Check ='r�f,-h. 1'iztr? Check ck Elec. Plan Check 0.0 hrs $0.00 Ale"::.:".rr' it�;> 1'; Elec.PermitFee: IEPERMIT other;t.l= L;i. Trrx,.,t��;-11i,;;,/, r _; ,.El Other Elea Insp. 0.0 hrs $48.00 Ifech. Insl;. PME Plan Check: $0.00 NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nictrirf of,- ) Thece feoc are ha.Ced an the nreliminary information available and are only an estimate Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 &f. 7-1/13 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Alternative Energy System $109.00 ICHRGSTA EV Charging Station Suppl. PC Fee: Q Reg. 0 O"1 0.p hrs $0.00 PME Plan Check: $0.00 200 amps Electrical $48.00 1 IBELEC200 Services Permit Fee: $0.00 Suppl. Insp. Fee1E) Reg. Q OT 0.0 1 hrs $0.00 0 Electrical $48.00 IBREMRECEP Recep/Switch/Outlets PME Unit Fee: $0.00 PME Permit Fee: $48.00 "onstructioil Administrative Fee: ]ADMIN $45.00 1 G) Work Without Permit? C) Yes (!) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 i Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: 1BSEISMICR $0.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $142.75 $205.00 TOTAL FEE: $347.75 Revised: 10/01/2015 Install one 240V 200A main electrical panel in place of the existing 100A main electrical panel. The existing utility service wires will remain overhead. Stucco will be patched after the installation. Install one 240V 50A dedicated circuit with a NEMA 14-50 receptacle in the garage for EV charging. The circuit will be ran in 6/3 Romex through the attic to the new NEMA 14-50 receptacle location. Install one new 240V 50A dedicated circuit for the existing kitchen oven. The circuit will be ran in 6/3 Romex through the crawl space to the existing oven location. OFFICE COPY Yi Xia & Han Ma 19911 Lindenbrook Lane Cupertino, CA 95014 (650) 243-7069 COMMUNITY DEVELOPMENT r.;LTPAPTMENT BUILDING DIVISION - CUPE-RTINO APPROVED This set of plans and specifications P.1 `T tre kept at the job site during construction. It is to make any changes or alterations on same, or to deviate therefrom, without approval from thO wilding Officiai. The Stamping of this plan and spec+`) - SH.aLL NOT be held to permit'. or to be an appr� of an ,,��`n�,pf any.0ty �r��.:ace or State Law. Y BY PE .:. _% PLO N CHECKED BY DA NI G DEPT CUPERT1 0 Building Department DEC 15 2015 REVIEWED FOR CODE COMPLY, NCE Reviewed By. Residential Electrical Load Calculation Site Location: Prepared by I L L O W Seema Handa Willow Glen Electric, Inc. L E Ni 7151 Glenview Drive PO Box 8430 LEC TRIC San Jose, CA 95120 San Jose, CA 95155 �/ I (408) 455-7764 (408) 289-9725 - office General Lighting and Receptacle Loads [220.12] 3 watts per ft' x 3,473 = 10,419 Small -Appliance Branch Circuits [220.52(A), 210.1(0)(1)] 1,500 watts x 2 = 3,000 Laundry Branch Circuit(s) [220.52(B), [210.11(C)(2)] 1,500 watts x 1 = 1,500 14,919 Fastened -In -Place Appliances [220.53] Kitchen Bath(s) Outisde/Miscellaneous Refrigerator(s) = 720 Instant Hot H20(s) = Exhaust Fan(s) = Hot Tub = Dishwasher(s) = 960 Hood Exhaust(s) = 240 Jacuzzi Tub(s) = Pool Equipment = Garbage Disposal(s) = 720 Gas Range(s) = Radiant Heating = H2O Pump = Microwave(s) = 1,560 Gas Oven(s) = = H2O Pump = Trash Compactor = 480 Wine Fridge(s) = = BBQArea = _ _ = Vacuum = Total Fastened -in-place Appliance Load 4,680 Clothes Dryer(s) [220 54] 80% x 240 x Derating Volts Amps 5,000 OR Name Plate Rating of Clothes Dryer = 5,000 Ranges, Ovens, Cooktops, and Other Household Cooking Appliances [220.55] x 24lt x 80s = 15,360 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 - 8.0 - Volts Amps Air Conditioning Unit 7,520 55% x 240 x 50 = 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 7,520 x 100% = 7,520 Electric Space Heating - x 100% = First 8kVA of all other loads 8,000 x 100% = 8,000 Remainder of all other loads 31,959 x 40% = 12,784 28,304 Total Current Minimum Amperes Current Minimum 28,304-. 240 = 117.9 17 Size Service or 200 Amps (voltage) (minimum amperes) Feeder [240.6(A)] currently Electric Vehicle [625.14] 125% x 240 x 40 = 12,000 Continuous Load Volts Amps , ,71 ^ U ^ ERT I N O Minimum Amperes with Added Load Minimum Size GLiiidI(1- r,- --,-nen ' -mer] Divide the total 40,304 _ 240 = 167.9 20 Service or Feeder: 200 Amps volt-amperes by (voltage) (minimum amperes) w/ Added Load with added load the voltage. [240.6(A)j NOTES All References are to 2014 National Electrical Code. REVIEWED FOR CODE COMPLIANCE Reviewed By: Th"aw�w Questions? Contact the Tesla Technical Support Team: Charging Installation@teslamotors.com 1650.681.6133 (Monday - Friday) 1877.798.3752 (24/7) INSTALLING YOUR 240 VOLT OUTLET The recommended home charging installation option for Tesla vehicles is a 240 volt NEMA 14-50 outlet. This outlet is commonly used for electric range stoves, large RVs and electric vehicles. Installed with a 50 amp circuit breaker, this outlet enables a recharge rate of about 25 miles per hour. Consult a licensed electrician to review the electrical load of your home prior to installation. Once the installation has been planned, the electrician can source a permit from your local building department to begin work. After installation, the electrician will schedule an inspection to approve the new electrical circuit. This guide provides reference for specifications to install this outlet. Since each installation is custom to the home, all hardware for the NEMA 14-50 outlet will be provided by your electrician. GROUND TO TOP NEMA 14-50 DETAILS • Voltage: Single phase, 208-250 Volt AC supply, 60 Hertz • Circuit Breaker: 50 Amp (125% overcurrent protection) • Operating Current: 40 Amp (maximum continuous current) • Conductors: 6 AWG, Copper Wire Only. Upsize wiring for installations over 150 feet • Ground Fault Circuit Interrupter: Not required • Service Disconnect: Not required • Receptacle Recommendation: High quality, industrial grade receptacle • Ventilation: Not required • Outdoors: Install with NEMA 3R rainproof enclosure • Electric Panel: Install circuit breaker as close to the utility feeder as possible to minimize voltage drop from other large circuits RECOMMENDED OUTLET LOCATIONS lfiw ® - Z3 o FOR YOUR RECORDS ELECTRICAL CO7 CUPERTWO 11 I Building Department PHONE NUMBER E DEC 15 2015 EMAIL ADDRESS j& CHARGE PORT REVIEWED FOR CODE COMPLIANCE � OUTLETS PERMIT NUMBER / Reviewed By: �4�-vol Install near vehicle charge port, maximum 15' away, minimum 18" above ground INSTALLATION DATE 3500 Deer Creek, Palo Alto, CA 943041 July, 2015 1 Version 1.6 T=5Ln a n lfiw ® - Z3 o FOR YOUR RECORDS ELECTRICAL CO7 CUPERTWO 11 I Building Department PHONE NUMBER E DEC 15 2015 EMAIL ADDRESS j& CHARGE PORT REVIEWED FOR CODE COMPLIANCE � OUTLETS PERMIT NUMBER / Reviewed By: �4�-vol Install near vehicle charge port, maximum 15' away, minimum 18" above ground INSTALLATION DATE 3500 Deer Creek, Palo Alto, CA 943041 July, 2015 1 Version 1.6 T=5Ln