B-2016-1344 PERMIT, APP, FEE EST, HOA LETTERCITY OF
CRICKET HILL RD CUPERTINO, CA 95014-2635 (342 35 011)
OWNER'S NAME: ZABOR ELIAS AND RUTH E TRUSTEE
OWNER'S PHONE: 408-446-3208
LICENSED CONTRACTOR'S DECLARATION
License Class C_10 Lie. #962034
Contractor (ALL BAY SOLAR I Date 02/1112016
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of tine 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:
h. 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.
z. I have and will maintain Worker's Compensation Insurance, as provided for
9-� by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
nformation is correct. I agree to comply with all city and county
ndinances and state laws relating to building construction, and hereby
mthorize representatives of this city to enter upon the above mentioned
aoperty for Inspection purposes. (We) agree to save indemnify and keep
[armless the City of Cupertino against liabilities, judgments, costs, and
>xpenses which may accrue against said City in consequence of the
Panting of this permit. Additionally, the applicant understands and will
:imply with all non -point source regulations per the Cupertino Municipal
Date 02111/2016
hereby affirm that I am exempt from the Contractor's License Law for one of the
dlowing two reasons:
r. 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 (See.7044, Business & Professions Code)
z. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sce.7044, Business & Professions Code).
hereby affirm under penalty of perjury one of the following three declarations:
a. 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.
2. 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.
a. 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.
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.
BUILDING PERMIT
CONTRACTOR: PERK
(ALLBAYSOLAR)
SAN FRANCISCO, CA
94112
DATE
PEON
BUILDING PERMIT INFO
B-2016-1344
ISSUED: 02/11/2016
NO: 415-624-3535
BLDG —ELECT _ PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
INSTALL (N) ROOFTOP MOUNTED SOLAR (2.46 KW) - 11 PANEL'S
Floor Area: evaluation: $11000.00
APN Number: Occupancy Type:
34235 011
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
by: PAUL O'SULLIVAN
RE -ROOFS;
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without fast obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date: 02/1l/2016
liful
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• Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Co �, km&25 25533, and 25534.
Owner or authorized ag nt: -_
Date: 02/il/2016
CO T LENDING AGENC
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
ARCHITECT'S DECLARATION
understand my plans shall be used as public records.
Date 02111/2016
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTI P10 (408) 777-3228 • FAX (408) 777.3333 - buildinp(o.cupertino.org
PROJECT ADDRESS Zp APN4 35 ®j
OWNER NAME VI10-5 �I '"'jam) o�
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PHONE n0_(�_446_'320
E-MAIL
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STREETADDRESS 2_ij q I fJ ��, C[RC I
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CONTACT NAME
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STREET ADDRESS
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FAX
1❑ OWNER ❑ OWIITR-BUEDER ❑ OWNERAGEN,TI XCONTRACTOR ❑ CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME Coc l0 5 e-
LICENSENUMBER 9 6,2U3^
LICENSE TYPEL_ 1
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BUS. LIC:
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COMPANY NAME /I II n(o-` SVLV_r'
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STREET ADDRESS n t7
CITY, STATE, ZI
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PHONE
L% � `624- 353 S
ARCIRTECTIENGINEER NA14B
LICENSE NUMBER
I BUS. LIC:
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
❑ COommerClal
PROJECT IN WILDLAND
URBAN INTERFACE AREAElYes ❑ NO
I ISTRUCTURE:
ZONE ❑ Yes ❑ No
Lq
SOLAR PANELS
❑ ELECTRIC VEHICLE CHARGING STATION
-❑ SOLARWATERHEATINO
❑ OTHER:
F0RS0L4RPANFLSr NUMBEROFPANELSNNITS: KILOWATTS(COMMERCIAL ONLY):
TOTAL VALUATION:
f !L�
DESCRIPTION OF WORK
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RECEIL'ED-Hf - MnTMO
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 verity it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to bui i 5r3struction. I authorize representatives of Cupertino to enter the above-identif d/ operty for inspection purposes.
Signature of Applicant/Aeent 1 -- Date:/fib'
PPLEMENTAL INFORMATION REQUIRED
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P 1C9pp_2011. doc revised 03116111
CITY OF CUPERTINO �-Xlb- 34L"
FEE ESTIMATOR - BUILDING DIVISION
IgADDRESS:
22918 Cricket Hill Dr
DATE: 02111/2016
REVIEWED BY: PAUL
APN: 342 35 011
BP#:
VALUATION:
$11,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
PENTAMATION SOLAR-RES
PERMIT TYPE:
WORK
INSTALL N ROOFTOP MOUNTED SOLAR 2.46 K - 11 PANEL'S
SCOPE
Ifech Plan Check
1'haah. Plan Check
Elec. Phm Checb
Ved. P, lem Fee:
Ptmnb. Pi?"a Pee:
Gtec Pe"em lyc
L1te-.P 3d•Ja. lxrsk,.
Ot rr Phw d> lmp_
t>! e+ h7: c. f±'.]U.
,Wech, lush. fic,
Ph mb. Iasp. ; aa;
FhW last. tee.
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 the preliminary information available and tyre onlv an estimate. Contact the Dept for addn7 info.
FEE ITEMS (Lqe &fLveLulion 11-053 L++ . 7111132
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
0 # Alternative Energy System
$236.00 1PTI0T0VRES Photovoltaic System
Suppl. PC Fee: e) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. 0 OT
0.0
1 Ins
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Cons/1 u(vion 7av
.rt[. rnhiistraiive Fec:
0
Work Without Permit? C) Yes (E) No
$0.00
Adv-gnced Plan ing'ce:
$0.00
Select a Non -Residential
Building or Structure �
e
rxrt;f iicrc rtier ralio;� fees:
Strom Motion Fee: I BSEISMICR
$1.43
Select an Administrative Ittemm
/ ---.
Bld- Stds Commission Fee: aCesc
$1.00
SUHTOTALS:`
$2.43
$236.000PAT
FEET
$238.43
Revis 01/01/20
RECEIVED
B
DE ANZA OAKS HOMEOWNERS ASSOCIATION
February 3, 2016
Elias Zabor
Lot 100, 22918 Cricket Hill Road
Cupertino, CA 95014
Dear Elias,
Regarding your application to install solar panels on your property, I am pleased to
inform you that your application has been reviewed & approved by the architectural
committee and Board of Directors.
As discussed and agreed in last night's monthly meeting, please be sure to inform and
consult with the association's roofing contractor Four Seasons Roofing of your project
to ensure the warranty of the roof is not voided:
Four Seasons Roofing
Al Diaz
(408) 278-0330;14
aldiazfsr@sbcglobal.net
Good luck with your project!
Sincerelyyours,
DEANZA OAKS HOMEOWNERS ASSOCIATION
C/O MAVERICKS REALTY MANAGEMENT
268 BUSH STREET, #4200, SAN FRANCISCO, CA 94104 (415) 691-7663