15120139lW
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10190 HILLCREST RD
CONTRACTOR: WILLOW GLEN
PERMIT NO: 15120139
ELECTRIC INC
OWNER'S NAME: MERRICK ROBERT G TRUSTEE & ET AL
1085 WARREN AVE
DATE ISSUED: 12/15/2015
OWNER'S PHONE: 4082181448
SAN JOSE, CA 95125
PHONE NO: (408)289-9725
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
Q
INSTALL (N) 50 AMP DEDICATED CIRCUIT W/NEMA 14-50
License ClassLic. # S �u
RECEPTACLE IN GARAGE FOR TESLA CHARGER
//
lJL 1/M S
Contractokpj l I�(d&t` Date
1 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
Sq. Ft Floor Area:
Valuation: $1190
performance of the work for which this permit is issued.
ave 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: 32616064.00
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 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 DoArYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
L
costs, and expenses which may accrue against said City in consequence of the
Issued by: Date: ( I� 1(5
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.
RE -ROOFS:
Signature ter/ Date 2 (S
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 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).
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 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
1 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, Sectio s 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: 5
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. 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 �I'1(�
AE
(408) 777-3228 - FAX (408) 777-3333 - buildinoAcupertino.org ll��''►►��
PROJECT ADDRESS /�f
%D/
APN #
396 16 �4-
OWNER NAME RPI.2ot�J
PHONE l/� j1- p /,//��
�61L e ® ` sem
STREET ADDRESS /D/QD d�
CITTA7'E.Ll \ Qi> O l SLrFA
!
CONTACT NAME Mark Londre
PHONE (408)289-9725
E-MAIL
low lenelectric.com
office@TFA
STREET ADDRESS p. O. Box 8430
CITY, STATE, ZIP San Jose, CA 95155X
(408)289-9725
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Mark Londre
LICENSE NUMBER 591918
LICENSE TYPE C-10
BUS. LIC # 15897
COMPANY NAME Willow Glen Electric, Inc.
F -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/FNGINEER NAME NSA
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 PANE/ S: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY):
TOTAL VALUATIO
DESCRIPTION OF WORK �e � 04 bl
Electric Vehicle Charging Circuit: ���2 � ���.�
awe: �oe-t,< >e&
[RECEIVED BY: i /r1 i SUJ i !r
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 II 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 buildingc ru ti nom} a bonze esentatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Appl icant/Agent: �� �� Date:
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
W
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OVER-THE-COUNTER
❑ EXPRESS
❑ STANDARD
❑ LARGE
❑ MAJOR
PVApp_2011.doe revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 10190 Hillcrest Rd DATE: 12/15/2015 REVIEWED BY: PAUL
Al
326 16 064 BP#: *VALUATION: 1$1,190
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition
PRIMARY SFD or Du lex PENTAMATION SOLAR -RES
USE: P PERMIT TYPE:
I
WORK Install N 50 Amp dedicated circuit w/Nema 14-50 receptacle in garage for Tesla Charger
SCOPE
NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public worKs, r/re, aanuary,3ewer v/srricr, acnoo/
n.-.-...• ..•.. 1 TG...... ! .,.... .. R.....,d .,.. 01. rawart the Dent for addn'l info.
FEE ITEMS (Fee Resolution I1-053 F . 71/13)
FEE
QTY/FEE7
MISC ITEMS
Plan Check Fee:
$0.00
1 #
$109.00
Alternative Energy System
1CHRGSTA EV Charging Station
Suppl. PC Fee: Q Reg00,1, O"1'
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -.0 Reg. Q OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
lrlrnrrt::313"cel. t't:' Fec:
0
(F)
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
�
I ,p)
Strong Motion Fee: 1BSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$1.50
$109.00
TOTAL FEE:
$110.50
Revised: 10/01/2015
Install one 240V 50A dedicated circuit w/ a NEMA 14-50 receptacle inside the
garage behind the existing 400A main electrical panel. The circuit will be ran
in 6/3 Romex.
OFFICE COPY
Bob Merrick
10190 Hillcrest Road
Cupertino, CA 95014
(408) 218-1448
RE
PLOT P
1C-%1NIU'JIT`( DE`lELOPPAENT'--EPAR1%1ENT
BUiLDiN':.:r DIVISION - CUPERT mn ;-
6/3 R"fKLVED SATE
P I G D PT
of plans acd specifications MUST be ept at th DUPERTINO
Job site during c_)rstr fiction. It is unlawful to _
changes or alterations on same, or to deviate _.._,.,.� CUPERTINO
nerefrom, without approval from the Building Official. :;` ;6 Building Department
-ire S'amping of this plan and specifications SHALL NOT .I
400A Main Panel (E) . e held toermr. or to be an approval gfJ8�'tlaud*80
P Pp �,)_ DSD 15 2015
w/ 50A breaker (N)
of an , ,ii of any City Ordinance or State Law.
BY �f _ REVIEWED FOR CODE COMPLIANCE
DATE 1 l
Reviewed By: gakv'z boJ
ED B`.
Residential Electrical Load Calculation
Site Location:
Prepared by J L L O W
Bob Merrick
Willow Glen Electric, Inc. L E N
10190 Hillcrest Road
PO Box 8430 LECTRIC
Cupertino, CA 95014
San Jose, CA 95155 �/
(408)218-1448
(408)289 -9725 -office
General Lighting and Receptacle Loads [220.12]
3 watts perftz x 4,445 =
13,335
Small -Appliance Branch Circuits [220.52(A), 210.1(C)(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
17,835
Fastened -In -Place
Appliances [220.53] Kitchen
Bath(s)
Outisde/Miscellaneous
Refrigerator(s) = 960 Instant Hot H20(s) = 960
Exhaust Fan(s)
=
Hot Tub =
Dishwasher(s) = 960
Hood Exhaust(s) =
Jacuzzi Tub(s)
=
Pool Equipment = 9,600
Garbage Disposal(s) = 600
Gas Range(s) =
Radiant Heating
=
H2O Pump =
Microwave(s) = 1,440
Gas Oven(s) =
Steam Shower
=
H2O Pump =
Trash Compactor =
Wine Fridge(s) = 480
=
Elevator =
_
_
=
30A Circuit =
Total Fastened -in-place Appliance Load
15,000
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]
80ti x
24
x 30s =
11,560
Derating
Voltt
Amps
AND/OR
Name Plate Rating of Cooking Appliances = 5,800
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
3,330
55% x
240
x 20 =
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
3,330
x 100% =
3,330
Electric Space Heating
-
x 100% =
First 8kVA of all other loads
8,000
x 100% =
8,000
Remainder of all other loads
41,395
x 40% =
16,SS8
27,888
Total
Current Minimum Amperes
27,898-.
240 = 116.2
Current Minimum
400 Amps
17 Size Service or
currently
(voltage) (minimum amperes)
Feeder [240.6(A)]
Electric Vehicle [625.14]
125% x
240
x 40 =
12,000
Continuous Load
Volts
Amps
Minimum Amperes with Added Load
Minimum Size
Divide the total 39,889 ;
240 = 166.2
20 Service or Feeder
Added Load
1
volt-amperes by
(voltage) (minimum amperes)
w/
i vinfF� l
the voltage.
[240,6(A)]
NOTES DEC 15 2015
rTry,
All References are to 2014 National Electrical Code. r,
O
lent
REVIEWED FOR CODE COMPLIANCE
Reviewed By: qhlp�11aw
Questions? Contact the Tesla Technical Support Team:
Charging Installation@ teslamotors.com 1650.681.6133 (Monday - Friday) 1877.798.3752 (24/7)
T=SLn
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 313 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
YOUR RECORDS
CUPERTINO
ELECTRICAL COMP f efl
PHONE NUMBER S 2015
REVIEWED FOR CODF C`nnnpl INCE
CHARGE PORT EMAIL ADDRESS
Reviewed By:
OUTLETS PERMIT NUMBER
j
nstall near vehicle charge port, maximum 15' away, minimum 18" above ground
T=SLn
I
INSTALLATION DATE
3500 Deer Creek, Palo Alto, CA 94304 1 July, 2015 1 Version 1.6