The URL can be used to link to this page

B-2016-1381CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR; PERMIT NO: B-2016-1381 821 BETLIN AVE CUPERTINO, CA 95014-4546 (369 27 019) ( SANTA CRUZ WESTSIDE ELECTRIC INC) SANTA CRUZ, CA 95060 OWNER'S NAME: BAGGA ANAND AND JAIN DEEPALI TRUSTEE DATE ISSUED: 02/17/2016 OWNER'S PHONE: 408-398-6360 PRONE NO: 831-469-8888 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CAA Lic. #846294 Contractor ( SANTA CRUZ WESTSIDE ELECTRIC INC ) Date 02/17/2016 X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL I hereby affirm tint 7 am licensed ender the provisions of Chapter 9 (commeociug _ with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: INSTALL 15 ROOF TOP, FLUSH MOUNTED PV MODULES (4.5kW) I hereby affirm under penalty of perjury one of the fallowing two declarations; 1. f 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. Sq. Ft Floor Area: Valuation: $15750.00 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 APN Number: Occupancy Type: ordinances and state laws relating to building construction, and hereby 36927 019 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal 180 DAYS FROM L PECTION. Code, Section 9.18. d/o�-- Issued by: MELISSA NAMES Signature ``V Date 021172016 Date: 92/17/2016 OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm Omt I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: installed without First obtaining an inspection, I agree to remove all new materials for 1. I, as owner of the property, or my employees with wages as their sale inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sce.7044, Business & Professions Code) Signature of Applicant; 2. 1, as owner of the property, am exclusively contracting with licensed Date: 02/17/2016 contractors to construct the project (Sec,7044, Business & Professions Cade). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Cade, for the HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 or the 2. 1 have and will maintain Worker's Compensation Insuronce, as provided for California Health & Safety Code, Sections 25505, 25533, and 25534. I will by Section 3700 of the Labor Code, for the performance of the work for which maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the this permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I exemptio Campc taws of California. If, after making this certificate o£ will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, ectlns 25505, 25, 33, and 25534. niQ sot exemption, 1 become subject to the Worker's Compensation provisions of the /f Labor Code, I nmSI forthwith comply with such provisions or this permit shall Owner or authorized agent: lhyeI/ be deemed revoked. Date: 02/17/2016 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Cie C.) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant ARCHITECT'S DECLARATION understands and will comply with all non -point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Signature Date 02l17/2016 Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 AE (408) 777-3228 • FAX (408) 777-3333 • buildinaCG7cupertino.ora PROJECT ADDRESS 821 Betlin Avenue APNk 3 6 , Z% - (/ 19 OWNERNAME PHONE E-MAIL Anand B a 8-3 - STREET ADDRESS 821 Betlin Avenue CITY''TATE, ZIPCu ertino, CA 95014 FAX CONTACT NAME Kristi Cassetta PHONE831-226-9363 E-MAIL kassetta@sandbarsc.com STREET ADDRESS 2119 Delaware Avenue Santa Cruz Ca 95060 FAX 831-515-5098 1 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT �u5 d CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCETTECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSETYPE BUS. LICN ej- 3 Sandbar 846294 C-10 C `S° GNveruz Westside Electric dba Sandbar E M�kcassetta sandbarsc.com FAX 831-515-5098 STREET ADDRESS 2119 Delaware Avenue CITY, STATE, ZIP Santa Cruz Ca 95060 PHONE 831-469-8888 ARCHITECT/ENGINEERNAME Sungevilty LICENSE NUMBER BUS. LIC 0 COMPANY NAME E-MAIL Sam - sholing@sungevity.com FAX STREET ADDRESS Franklin Street Ste, 310 GITY.RTATCakland CA 94607 PHONE USE Or yypp6yy6 SFD Or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE' ❑ Commercial ��{,5, URBAN INTERFACE AREA El Yes Yes No FLOOD ZONE [IYes ElNo IN SOLAR PANELS ❑ ELECTRIC VEH]CLE CHARGING STATION ❑ SOLAR WATER HEATING El OTHER: FOR SOLAR PANELS, NUMBER OF PANELS/UNr1'S: KILOWATTS(GBM#4FR2FAbBP{};b' - TOTAL VALUATION!$15,750 Y� DESCRIPTION OF WORK Installation of a 4.5kw grid tied photovoltaic solar array roof mount By my signature below, I certify to each, fthe ollowing: 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 hav pr . ed is corn . 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 ai din nstn 0 . I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicanUAgent / Date: 2/16/16 S PPI; MENTAL INFORMATION REQUIRED OFFICE use ONLY W ❑ OVER-THE-COUNTER m F ❑ EXPRESS V -❑ STANDARD z5 a ❑ LARGE 0. ❑ MAJOR`. PVApp_2011.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 821 BETLIN AVE DATE: 02117/2016 REVIEWED BY: MELISSA APN: 369 27 019 BP#: `"VALUATION: 1$15,750 "PERMIT TYPE: Building Permit PLAN CHECI{ TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION SOLAR-RES PERMIT TYPE: WORIc INSTALL 15 ROOF TOP FLUSH MOUNTED PV MODULES 4.5KW SCOPE t1 1 „r:wh. rec: ,' )ggii ri e. #h- 34td. imp, t1 '�' f ee �ih lit:�l.El f), et -7(, l! h ', tl i:. Insfz Iree: t Ir Its. ftra('. 1-F�<, f;rr /mr ;Pr--. NOTE: This estimate floes not inchtde fees tlite to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer Dish•iet, School District ete.. These.fees are based on the rrelimdnar information available and are only an estimate. Contact the Dept for ad(In'1 hilb, FEE ITEMS (Fee Resolution 11-053 Af 7/1/13i FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Alternative Energy System $236.00 IPHOTOVRES I Photovoltaic System Suppl. PC Fee: (E) Reg. () OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.-OT-Ins $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Cousir-n wn 7ov Q Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: - $0.00 Select allon-Residential Building or Structure l;yE„ Strong Motion Fee: IBSEISMICR $2.05 Select an Administrative Item Bldg Stds Commission Fee_ IBCBSC $1.00 SUBTOTALS: $3,05 $236.00 TOTALFEE: 1 $239.05 Revised: 01 /01 /2016