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15110038CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7772 SQUIREHILL CT CONTRACTOR: SOLARCITY PERMIT NO: 15110038 OWNER'S NAME: REBECCA TUCKER 3055 CLEARVIEW WAY DATE ISSUED: 11/06/2015 OW ER'S PHONE: 4084241218 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ License Class(" 10 , C& ') Lic. # IME Q I Q q INSTALL (22) ROOFTOP FLUSH MOUNTED SOLAR PANELS (5.72 KW; INSTALL (N) 125 AMP SUB -PANEL. Contractor I, A' Date lacI115 I hereby affirm that I am license 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: $12500 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 APN Number. 36223025.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which m accrue against said City in consequence of the granting of this permit. Add on the applicant understands and will comply Issued by: Date: with all non -point source r ulatiboper the Cupertino Municipal Code, Section 9.18. ' RE -ROOFS: Signature Date i 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 1, 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 equipme t 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 Areal it lity Management District I performance of the work for which this permit is issued. will maintain compliance with the Cuperf Muni pal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2550 5533, nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued, l shall r 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 (See. 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 ALTERNATIVE ENERGY PERMIT APPLICATION j °...� ,s, yl- i ti ;?`� , �t 'illAJ �� i'�, , I ✓SEN i t6- o. 1;1AE1 CUPERTIN0 PROJECT ADDRESS C' VL j j"c- V\ l ' APN k ObVNF,RNANfE ^�' PHONE . ` E-NIAIL STREET ADDRESS t C,: �,`.��1 `�� �.J 1 CITY, STAT�E,7_[ i � q5n FAX p IHONL650.477.6430 E-"'A'Lmjavanmard@solarcity.com CONTACT NAME Marjan Javanmard STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER-BUMDER ❑ OWNER AGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NANIE SolarCity Corporation LICE NSENUM '888104 LIC ENSETYPEC10 BUS. LIC k28840 COMPANY NAME SolarCity Corporation E-MAILmjavanmard@solarcity.com FAX STREETADDREss391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PH°N'650.477.6430 ARCHITECTIENGINEER NAME LICENSE NUNIBER BUS. LIC k 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 PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): m TOTAL VALUATION DESCRIPTION OF WORK Installation rooftop flush mounted solar panel () kW RECEIVED BY: w By my signature below, I certify to each of the following: I vn t props owner or authorized agent to act on the property owner's behalf. I have this application and the information I have provided is correct. I hav read 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 g representatives of Cupertino to enter the above -identified props for inspection purposes. Signature ofApplicant/Agent: ., t/t Date: C9 l SUPPLEMEa fA FORMATION REQ7nD . —_ OFFICE USE ONLY —_—� �------- -- - v F E U U U a a ❑ OVER-THE-COUNTER ❑ EXPRESS E]STANDARD ❑ LARGE ❑ MAJOR Mpp_2011.docrevised 03116111 CITY OF CUPERTINO F -M7 FEE ESTIMATOR - BUILDING DIVISION 1AADDRESS: 7772 Squirehill Ct DATE: 11/06/2015 REVIEWED BY: Phuong A9cch. Permit Fee. APN: 362-23-025 BP#: *VALUATION: 1$12,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Phmrh. Imp. Fee: PENTAMATION SOLAR -RES PERMIT TYPE: WORK Install 22 rooftop flush mounted solar panels 5.72 KW); N 125 amp sub -panel. SCOPE 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 nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711113) A,fcch. P/ori Check Phmcl, Plan Check Elec. Plan Check 0.0 hrs $0.00 A9cch. Permit Fee. P/umb. Per,nil Fcc. Elec. Permit Fee: IEPERMIT Ocher!Vfcch. Insp. Other Phmih his/,_Li Other Elec. Insp. 0.0 hrs $48.00 Alech. hA.,p. Fee: Phmrh. Imp. Fee: Ncc. Insp. Fee: 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 nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $236.00 Alternative Energy System /PHOTOVRES Photovoltaic System Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 125 1 amps $48.00 Electrical 1 1BELEC200 Services Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 Coizswnction Tax Administrative Fee: (ADMIN $45.00 G Work Without Permit? 0 Yes E) No $0.001 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G i Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee. IBSEISMICR $1.63 Select an Administrative Item Bldg Stds Commission Fee: /BCBSC $1.00 SUBTOTALS: $143.631 $284.00 TOTAL FEE,: $427.63 Revised: 07/02/2015 CUPERTINO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 X08) 777-3228 • FAX (408) 777-3333 • building(aDcupertino.org „ Owner Name 5C o / u c- k e, r Permit No. Address 7774 Cts e,&4; wP, C '?S -01V 1. Is your real property a registered historical "site? ❑ Yes Civil Code Sections 1101.1 thrr gh 1101.8 do not apply. Skip the rest of the form and sign bottom of form. N No Go to Question 2. � 11714 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 110 1. 1 through 110 1. 8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the fonn and sibottom of form. No Go to Question 3. J�iDv 1(7/ b ll S 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 110 1. 1 throu h 1101.8 do not apply. Skip the rest of the form and sign bottom of form. VA No 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. Yes My real property 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.. -0 1111611s- Please 1 fr61/S' Please check ONE of the following: XJ My property is a single-family residential real property. See Civil Code Section 1101.4. ,,R111/611S- 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 irnprovernents 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 follOWll1Q t)a�ze. i I Owner or Owner Agent's Signature: _ /Reil Date: 11 /6 //-r I Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015. doc revised 08/26/15 CVPERTINO 085MOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF C0M9 UANCEFILE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION C7S 10300 TORRE AVENUE o CUPERTINO, CA 95014-3255 (408) 777-3228 o FAX (408) 777-3333 • buiIding Qcupertino.org iffmams 777Z Sr a '.-e_4;11 0, Cope,,P,%M PERNUT CANNOT DE 1FINALED AND COMPLETED UNTIL TIIIS CERTIFICATE TIAS I,EtN a LQ_1N EjD ANBD . �. !` l TO THE B*IJI .,DTNG 3JMSIOTN 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 CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X 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 -burning 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 California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and conditions of this statement �v��6t_ or _ PvnerAgertt'sl-Name: 5c- a,&— 7—u C<C✓ Sl natUle.. /............................................................................................... 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