16010006CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10316 VIRGINIA SWAN PL CUPERTINO CA 95014 (316 46 007)
CONTRACTOR:
SOLARCITY
391 FOSTER CITY BLVD
PERMIT NO: 16010006
OWNER'S NAME:
PHONE NO: 650-477-6430
LICENSED CONTRACTOR'S DECLARATION
License Class C-10, C-20 Lic. #888104
Contractor SOLARCITY Date 02/10/2016
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:
1.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.
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
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.
Signature___________________________________ Date 02/10/2016
OWNER - BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor’s License Law for one of the
following two reasons:
1.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)
2.I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
1.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.
3.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.
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 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.
Signature___________________________________ Date 02/10/2016
BUILDING PERMIT INFO:
BLDG ELECT PLUMB
MECH RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
INSTALL (51) ROOFTOP MOUNTED SOLAR PANELS (12.75
KW); UPGRADE (N) 125AMP PANEL.
2/10/16 - DECREASE PANEL COUNT FROM 51 TO 48 (12.48kW)& ADD
(N) 125 AMP SUB PANEL
Sq. Ft Floor Area: Valuation: $29000.00
APN Number:
316 46 007
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: MELISSA NAMES
Date: 02/10/2016
RE-ROOFS:
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.
Signature of Applicant:_______________________________
Date: 02/10/2016
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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 Code, Sections 25505, 25533, and 25534.
Owner or authorized agent: ________________________________
Date: 02/10/2016
CONSTRUCTION LENDING AGENCY
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
Lender's Address
ARCHITECT’S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional________________________________________________
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10316 VIRGINIA SWAN PL
CONTRACTOR; SOLARCITY
PERMIT NO: 16010006
OWNER'S NAME:
SAN MATEO, CA 94402
PHONE NO: (650) 638 -1028
Li' LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL
COMMERCIAL ,Q
INSTALL (51) ROOFTOP MOI
NTED SOLAR PANELS (12.75
License Class
KW); UPGRADE (N) 125AMP PANEL.
Contractor. Date g? Gr
I hereby affirm that 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: $29000
performance of the work for which this permit is issued.
J-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: 31646007.00
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 V
70RK 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 may accrue against said City in consequence of the
Issued by:
Date: f 4 116
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
RE-ROOFS:
If is
9.18.
�'�
Date
All roofs shall be inspected prior to any roofing
material being installed. a roof
installed without first obtaining an inspecti
inspection.
n, I agree to remove all new materials for
❑ 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 MAT
RIALS DISCLOSURE
construct the project (Sce.7044, Business & Professions Code).
I have read the hazardous materials requirements
under Chapter 6.95 of the
California Health & Safety Code, Secti
s 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertin
i 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.
will maintain compliance with the Cupertino
rea Air Quality Management District I
Municipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
the Health & Safety Code, Sec loom 5
5, 25533, and 25534.
I have and will maintain Worker's Compensation Insurance, as provided for by
t
Section 3700 of the Labor Code, for the performance of the work for which this
.
Owner or authorized agent:
Date: i
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
Code, I
I hereby affirm that there is a construction
lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor must
work's for which this permit is issued (Sec.
3097, Civ C.)
forthwith comply with such provisions or this permit shall be deemed revoked.
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'3
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 pu
lic 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
CITY OF CUPERTINO
FF.T. FSTTN4ATnR — RTTTT. -nfNG nTVTRION
ADDRESS: 10316 Virginia Swan PI
DATE: 01104/2016
REVIEWED
BY: Phuong
APN: 316 46 007
BP #:
*VALUATION:
1
1$29,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE:
Alteration / Repair
PRIMARY
USE: SFD or Duplex
$0.00
PENT
PER
MATION
IT TYPE: SOLAR -RES
WORK
Install 51 rooftop mounted solar panels 12.75 KW); N 125amp panel.
F 125
SCOPE
Services
Permit Fee:
' Elec. Plan Check hrs $0.00
Elec. Permit Fee: IEPERMIT
. 3E � ' Other El-,c. �. Insp. hs Aleck z >. 13;;E- ;rs..
:. l fe- ir,.wj
_
NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire Sanitary Sewer District, School
. ___ 1. _ __ ih, n...i f— ndd »,7 infn-
,u1slydct, etc.. inesefees ure maeu urt free reler/eereue
FEE ITEMS (Tee Resolution 11 -053 Eff. 711113)
m w niuccvrc uru.cxw•.w
FEE
...•..w .••--
QTY /FEE
�• -- -- -_ _.. __________
_ ____ _. _
MISC ITEMS
Plan Check Fee:
$0.00
1
# Alternativ,
Energy System
Photovoltaic System
Suppl. PC Fee: ( Reg. 0 OT
0.0
hrs
$0.00
$236.00
IPHOTOVRES
PME Plan Check:
$0.00
F 125
amps Electrical
Services
Permit Fee:
$0.00
$48.00 IBELEC200
Suppl. Insp. Fee-G) Reg. Q OT
Q,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
:'r, irc:t €srt Mx:
M_
Administrative Fee: 1ADMIN
$45.00
0
Non - Residential
Building or Structure
,'
Work Without Permit? 0 Yes (j) No
$0.00
$0.00
Select a
Advanced Planning Fee:
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: 1BSEISMICR
$3.77
Selee
an Administrative Item
$43
°QTAL FEE = 0 77
n _. .._. J. AA /llA l7n4G
Bldg Stds Commission Fee: 1BCBSC
SUBTOTALS,
$2.00
$146.77
84
$2 . 00
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