15120176K
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10650 CASTINE AVE I CONTRACTOR: SOLARCITY I PERMIT NO: 15120176 1
OWNER'S NAME: NIEH TAI -GANG AND CHANG CHIEN -I
OWNER'S PHONE: 4083864547
LICENSED CONTRACTOR'S DECLARATION
License Class 0 CJ t Lic. #s Ul5 k b q
Contractor & Lwoz_i'1 n Date 1 I 5
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:
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.
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 l 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 ccrue against said City in consequence of the
granting of this permit. Addi nally e applicant understands and will comply
with all non -point source re atio er the Cupertino Municipal Code, Section
9.18. qq 'K
'Signature Date Ioc- i V
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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
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.
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
3055 CLEARVIEW WAY I DATE ISSUED: 12/21/2015
SAN MATEO, CA 94402 1 PHONE NO: (650) 638 -1028
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑
INSTALL (15) ROOFTOP FLUSH MOUNTED SOLAR PANEL
(3.9 KW)
Sq. Ft Floor Area: I Valuation: $8500
I APN Number: 32643030.00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: �A� - Date: I h 2
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:
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 'r Quality Management District I
will maintain compliance with the Cupertin un' ' al Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 533 rd 25534.
Owner or authorized agent: Date: oC.�
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
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT m BUILDING DIVISION
� R 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
1 1 (408) 777 -3228 FAX (408) 777 -3333 • building cupertino.org
CUPERTINO
U#
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PROJECT ADDRESS 9 € r & ; .:� f 1 Ia
TAPN # 3 /1 /J� �*y b )
pLE7MAIL V (J
OWNER NAME . e�9't,e -r
�� �� Q�s
PHONE �;
of hi> (� I it A .
STREET ADDRESS P
CITY, STATE, ZI q g k LI
C k @ .. ^mac
FAX
CONTACT NAME
Mar }an Javanmard
PHONE
650,477.6430
E -MAIL m•avanmard solarcit .com
@ y
STREET ADDRESS 391 Foster City Blvd
aWNER-
p
CITY, STATE, ZIP Foster City, CA 94404
FAX
❑ OWNER ❑ O BUII.DER ❑OWNER AGENT ❑ CONTRACTOR. IN CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 0 TENANT
CONTRACTORNAMESolarCity Corporation
`7 v t
LICENSENUMBER484104
LICENSE TYPE C10
Bus- LIC #2$$40
U(J
COMPANY-NAME
SolarCity Corporation
E -MAIL mjavUanmard solarcit .com
J @ Y•
Fes'
STREET ADDRESS 391 Foster City Blvd
CITY, STATE, ZIP Foster City, CA 94404
PH°lIE650.477.6430
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC #
COMPANY NAME E -MAIL FAX
CITY, STATE ZIP PHONE
STREET ADDRESS
USE OF EVSFD Or Duplex ❑ Multi- Family PROJECT IN WILDLAND PROJECT IN
El Yes I] No FLOOD ZONE E] Yes ❑ NO
STRUCTURE: Commercial URBAN INTERFACE AREA
s
SOLAR PANELS . WATER HEATING ❑ OTHER:
El ELECTRIC VEHICLE CHARGING STATION E3 SOLAR
KILOWATTS (COMMERCIAL ONLY): TO AL V ATION:
FOR SOLAR PANELS: NUMBER OF PANELS�TS: e ,
--s
DESCRIPTION OF WORK
Installation 5) rooftop flush mounted solar panel (2�- 9f ) kW
e wner or authorized agent to act on the property owner's behalf. I hav ead this
information I have provided is correct. I have th escnphon of Work and verify it is accurate. I agree to comply with all applicable local
P,i low, I certify to each of the following: I am the p p rty
e laws relating to building constructi on. I�ye zep ntatives of Cupertino to enter the above-identified - identi d propel} for inspection purposes.
PVApp 2011. doe revised 03116111
CITY OF CUPERTINO
1ww IWVIW 1W Q'"1%4 A 9rt-112 — TZITII .DING DIVISION
ADDRESS: 10650 Castine Ave DATE: 12121/2015
REVIEWED BY: Phuong
APN: 326 43 030
1 BP#:
* VALUATION: [$78,500
h *PERNHT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION SOLAR-RES
I PERMIT TYPE:
WORK
Install 15 rooftop flush mounted solar panel (3.9 KVV)
SCOPE
7777777-1�
NOTE: This estimate does not in clu defees due to other D ep artments, (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
'. I I-- n--4 'r— -,1,4. 1 ;"fn
District, eta). These fees are based on the preliminarp
FEE ITEMS (Fee 12esolution .11-053 Ef.
L 7/1113)
Plan Check Fee:
Suppl. PC Fee: (j) Reg. 0 OT FO
_7 .0 hrs
PME Plan Check:
Permit Fee:
Suppl. Insp. Fee- (F) Reg. 0 OT 0.0 hrs
PME Unit Fee:
PME Permit Fee:
Work Without Permit? 0 Yes No
Advanced Planning Fee:
F ees'.
Strong Motion Fee: IBSEISMICR
Bldg Stds Commission Fee: IBCBSC
IiSTOTALS
7777
7
FEE
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
tante ana are ur-Y Lilt
QTY/FEE MISC ITEMS
# Alternative Energy System
$2376 00 FJPHOWVRES Photovoltaic,
$1.11 -
$1.00
$2.11 $236.00
Select a Non-Residential
Building or Structure 0
Select an Administrative Item
CBEs ( $238.11
Revised: 10101/2015
CUPERTINO
Address
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 a buildingDcupertino.org
(� Permit No ��� � �
06� L.�tS�IAve l'�•tlOei- kL # ofAlarms Smoke: .$_ Carbon Monoxide: 2-
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.
1 have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agents Name:
rot
� �
�. r
Si nature ... ..............................................:................................. ..........I.........I.......... Date: ... ............
Contractor Name:
Signature...................................... .................... I ....... ..Lic. # ...................................... Date: ...................
CUPERTINC
WATER - CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION
10300 TORRE AVENUE ^ CUPERTINO, CA 96014-3255
(4 8) 777 -3228 o FAX (408) 777 -3333 m building(ftuper ino.org
Owner Namef IP +P r PIILV Permit Not
Address 1,0bs -a Cot5A-A,w Alr, Cc,tr/!�;ri-. , C� Ol Y
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 1
KNo Go to Question 2.
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 1101.1 through 1101.8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
7' No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
W1 No Go to Question 4. G C
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..
5. Please check ONE of the following:
My property is a single-family residential real property. See Civil Code Section 1101.4.
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 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).
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 110 1.8, 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 following pale.
Owner or Owner Agent's Signature
Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit.
SB4072015.doc revised ON6115
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