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15120169I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10095 JUDY AVE I CONTRACTOR: SOLARCITY I PERMIT NO: 15120169 OWNER'S NAME: CHRISTENSEN SOREN AND METTE 13055 CLEARVIEW WAY DATE ISSUED: 12/18/2015 I OWNER'S PHONE: 4085044450 1 SAN MATEO, CA 94402 1 PHONE NO: (650) 638 -1028 I LICENSED CONTRACTOR'S DECLARATION License Class i ? 6 Lic. # S? 10 ' Contractor x I iai j. -i Date I 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 forwhich 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 accrp against said City in consequence of the granting of this permit. Additional thfra'licant understands and will co y with all non -point source regulat ns pei t e Cupertino Municipal Code, ection 9.18.. ;% JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL INSTALL 22 ROOF TOP, FLUSH MOUNTED PV MODULES (5.72 KW) Sq. Ft Floor Area: I Valuation: $12500 1 APN Number: 37507050.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 18 ERMIT ISSUANCE OR I EI3QM CALLED INSPECTION. Issued by: .. a Date: l RE- ROOFS: _ Date E� 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 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 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 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 Air Quality Management District I will maintain compliance with the Cupertino nicl 1 Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25 3, at}25534. Owner or authorized agent: Date: 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 ALTERNATIVE ENERGY PERMIT APPLICATION CClMl+ UNi i Y DEVELOPMENT DEPARTMENT = BUILDING DIVISION' 10300 TORRE AVENUE • CUPERTINO, CA :5014 -33255 (408) 777-3226 -FAX (413) 777 -3333 -building Cwcup6 tino.orc . l lZ PROJECT ADDRESS l o o q a e 41 V C- APN OWNERNAME is 0 m_ r\ 'k f 1 sf cx- )s 4 P�H�OgNE �p��6 E- MAIL STREETADDRESS !" [ / CITY, STATE ZIP FAX � I J C-A " I - CONTACT "'Marian Javanmard P"E 650.477.6430 E -MAIL mjavanmard @solarcity.com STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑CONTRACTOR CONT RA CTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑- DEVELOPER ❑TENANT CONTRACTORNAMESolarCity Corporation LICENSENUMBER888104 LICENSE TYPE C10 BUS.LIc #28340 V COMPANYNAMESolarC ty Corporation E-MAIL mjjavvani1 "lard @solarcity..Ciom F"X STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, . CA 94404 PH°' 650.477..6430 ARCHITECT/ENGINEER NAME. LICENSE NUMBER BUS. LIC 9 COMPANY NAME E- MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or DUpleX ❑ MUIti-Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT IN FLOOD ZONE ❑ Yes 11 No i SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): _ TOTAL VALUATIONI a ) t } DESCRIPTION OF WORK Installation 1) rooftop flush mounted solar panel (j,19-) kW BY. By my signature below; I certify to each of the following: I am theiropeyty wner or author' agent to act on the p peri0odp,.p.,PLy wner' alf. I have read this application and the information I have provided is correct. I have,. tl}e escription of Work and verify it is accurate. I comly with all applicable local ordinances and state laws relating, to building construction. I a tiro i presentatives of Cupertino to enter the above -iden for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENT FORMATION UTRED OFFICE USE ONLY u U_: U a❑ r., ❑ OVER-THE-COUNTER EXPRESS .. ❑ STA"A" LARGE MAJOR PVApp_2011.doc revised 03116111 FI-M-ft CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10095 JUDY AVE DATE: 12118/2015 REVIEWED BY: MELISSA APN: 357 07 050 BP #: *VALUATION: 1$12,500 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION SOLAR -RES PERMIT TYPE. WORK INSTALL 22 ROOF TOP FLUSH MOUNTED PV MODULES 5.72 k SCOPE PME Plan Check: In ieck CJ 1lei "f s �?; lllui }u;,?. Pt' 1 E'r. 1-116", Perini 1 ce. 1. 3. 1 13 IY',:ti, ii f`..s`,'L :; t e'C'. ins", NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Th b d If Z'minar in ormation available and are only an estimate. Contact the ue t Tor aaan a cn u. Distract, etc.. ese ees are me on ze re t FEE ITEMS (Fee Resolution 11 -053 E&'711173) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 = # Alternative Energy System $236.00 1PHOTOVRES Photovoltaic System Suppl. PC Fee: Q) Reg. 0 OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 L T7'ZaYi fi'dtbTC. 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure Strom Motion Fee: IBSEISMICR $1.63 Select an Administrative Item Bldg St ds Commission Fee: rBCBSC $1.00 sB`r'oTA. < $2.63 $236.00 $238.63 : rxcv iacu. x L: J CUPERTINO Owner Name Address WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE.AVENUE • CUPERTINO, CA 95014 -3255 777 -3228 • FAX (408) 777 -3333 • bdiding a?cuoertino.org 1��jit .vti Permit No. I I Z C) tVl r Please refer to the attached California Civil Code Sections 1101.1 - 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: .�No Go to Question 2. Date: 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water - conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plurnber's certification has been provided to the Building Division. Sign below and skip. the rest of the form. Owner' Signature: [�T No. Go to Question 3. Date: 3. Is water service pennanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: ,K-No Go to Question 4. Date: 4. Is your real property built and available for use or occupancy on or before January 1, 1994? No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form Owner' Signature: Date: ❑ Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. l$ My property is a single family residential real properly. 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 - cornpliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily reside7ldal 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 - cornpliant 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. SB407 2014. doc revised 03118114 On or before plVmbm*`g AkHie­ s, s eerep lk with water{ - plumbing fixtures throughout. the; building., (regardless r Rardless er of` �,,,k�rh whether pro ty, undergoes or e p improvements). IfWe, the owner(s) of this property, certify under penalty `6�ury pen that noii-'Cbiripliant plumbing fixturps`,_4a�6been replaced with water-conserving plumbing . fixtures in Oc r �e' � I ith Civil Code Sections; 1101,1 through 1101.8) the : 6 * melit California Plumbing Code and California *(�fe- B St dards Code, and manufacturer's installation requirements, and -,g that the water-conserving pfumbing,fixturh§��r�,- requirements as-indicated in the table below. L turhs) WA I I Y'/ JZI z Owners (or Owner Agent's) Signature: Date: Upon completing and signing this Certificate, please- return it to the Building Division in order to final your permit. 1. If the existing plumbing fixture water usdg'e/fl'o"'w','r"afe"is"e"'q"'ual't'o' I& lower ',thKthe fip b showh, it is not required to be upgraded. SB40 7 2014. doc revised 03118114 N6h-'C6mpliefnt et= C6'hi`e'iVln"" Plumbing Fixture Plumbing Fixture I (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usagd/Fl6w Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4.. 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 0ALGr6erI DiV. 4.3 2013 CALGre'en Div. 5.3 Single-Family MUlti-Faimily Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gall6hs/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush Volume (the composite, average flush volume of two reduced flushes and one full flush) Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute'@ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Sh6werheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucels — Exceed 2.2 gallons Maximum 1.5 gallons. per,,. Within units:, 0.5 gallonsper minute @ 60 Lavatory per minute minute ,@, 60 psi; -rhiniftium Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi' In common-and public I areas: 0.5ballons use per mlnOteg 60 psi 1.8 gallons per minute @ 60 psi Faucets — Exceed 2.2 gallons 1.:8 gallons per minute @ 1-:8-;gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @, 6 0 psi psi Faucets May temporarily increase May temporarily Up to. 2:2 gallons per -increase Up to 2.2 minute @W:psii-and must gallons per. minute@ .::;default-,toimaxiMwm.....::t,- .%psij,,,and must. j gallon pe minute.-&��:, -,j e btJlttb:makiffiumI - 60 psi ;;158 gallons per minute Where faucets meeting 60 psl thbbbove'are, unavailable, H! IE66;ts..mdeting aerators '"' o� ot h er,means th e", a ' o ve are maybe used tp,.ac [eve Qh*6VbIlabI6`,t'beratoJrs or reduction other ` . means "_Mpy, b- dj­` use b achieve Q067` fiO' 1. If the existing plumbing fixture water usdg'e/fl'o"'w','r"afe"is"e"'q"'ual't'o' I& lower ',thKthe fip b showh, it is not required to be upgraded. SB40 7 2014. doc revised 03118114 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 ^ buildinq@cuipertino.org 1 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. l have read and agree to comply wi(h the terms and conditions of this statement Ow er (or Owne Age t' s) Name: Sign .............. Y..... }.... �...r . �... Date: ....... Si nature .................. w :. ,........... Gc:# :.. .:.. :.......................... Date: �. 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