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B-2016-1249
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1249 7481 ROLLINGDELL DR CUPERTINO,CA 95014-5812(359 32 011) SOLARCITY CORPORATION SAN MATEO,CA 94402 OWNER'SNAME: SRIVASTAVA BIKRAM AND ANJALI DATE ISSUED:0 1/25/2016 OWNER'S PHONE: PHONE NO:(650)963-4722 LICENSED CONTRACTOR'S DECLARATION BUILDIXINFO: License Class WARM-AIR HEATING VENTILATINGAND AIR-CONDITIONING Lie.#888_104 X BLDG —ELECT —PLUMB Contractor SOLARCITY CORPORATION Date 12/31/2016 MECHAL_CO RCIAL 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 JOB DElicense is in full force and effect. INSTALL -' SH M T M U (3.12 kW) I hereby affirm under penalty of perjury one of the following two declarations: i. 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 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 Sq.Ft I or Ar a: Valuation:$6500.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above PN Number: Occupancy Type: Information is correct.I agree to comply with all city and county ordinances 359 32 011 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)a/dh o save indemnify and keep harmless a PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabjudgments,costs,and expenses ich WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue against said Cityinconsequence of the granting of thi ermit. Additionally,the applicant unnds and will comply with all -point 180 DAYS FROM LAST CALLED INSPECTION. source regulations per the Co Municipal Code,Sectio .18. Issued by:MELISSA NAMES Signatureto Date:01/25/2016 OWNER-BUILDER DECLAN RE-ROOFS: I hereby affirm that I am exem the tractor's License Law for one of the All roofs shall beinspected 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 pro y employees with wages as their sole inspection. compensation,will dork,and the structure is not intended or offered for sale(Sec.7044,Busi Professions Code) Signature of Applicant: 2. I,as owner of the property,am exclusively contracting with licensed Date: contractors to construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will Section 3700 of the Labor Code,for the performance ofthe work for which this maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 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 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,atter making this certificate of the Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent' be deemed revoked.. Date: 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,Civ 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 Lender's Address 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 ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Professional Signature Date a lay. April 05, 2016 Dear Sir or Madam: This letter is to inquire about cancelling the permit for the following customer: Bikram Srivastava 7481 Rollingdale Dr. Cupertino CA, 95014 Permit# B-2016-1249 The customer has decided to cancel their solar project with SolarCity. We hereby request a refund of fees, If possible. Refund checks can be mailed directly to the following address: ATTN: Iona Villalba SolarCity Las Vegas 6671 S. Las Vegas Blvd Ste. 300 Las Vegas, NV 89119-3290 If you have any questions or need anything further, please let me know. Sincerely, Marjan Javanmard, Permit Coordinator (650)477-6430 miavanmardd@solarcity.com M clear:ic1W Way Son Nlat €, GA 94402 T NJEDO)06.1 .98 (886)$0I411TY r(650) 300�'Nti SOLARCITYXOM .ns Fti, e ': 1 0F-ytq A:zi1,]'s U,) rf? <, : c;fs CITY OF CUPERTINO BUILDING PERMIT BIRLDINGADDRESS: CONTRACTOR: PERMIT NO:B-20I6-1249 7481 ROLLINGDELL DR CUPERTINO,CA 95014-5812(359 32 011) (SOLARCITY CORPORATION) SAN MMEO,CA 94402 OWNER'S NAME: SRIVASTAVABIKRAMAND ANJALI DATE ISSUED:01/25/2016 OWNER'S PHONE: PHONE NO:650.477-6430 LICENSED CONTRACTOR'S DECI ARMION BUILDING PERMIT INFO: License glass C-10 Lic.# 104 Contractor(SOLARCiTY CORPORATION)Date 01125/2016 X BLDG ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL—COMMERCIAL with Section 7000)ofDivislon 3 ofthe Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations: INSTALL 12 ROOF TOP,FLUSH MOUNTED PV MODULES(3.12 IM a. 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. Sq.Ft Floor Area: Valuation:$6500.00 LlM7CANT CEWT FICATION 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 95932011 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, be ap #cant understands and will comply with all non-point source r ulali per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code,Section 9.18. - Signature Date 0112512016 Date:01I251�16 O�YWA R4= UIT.DL DECr ARATION RE-ROOFS: I hereby affirm that 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 sole inspoction. compensation,will do the work,and the structure is not intended or offered for We(Sec.7044,Business&Professions Code) Signature of Applicant: 2. I,as owner of the property,am exclusively contracting with Licensed Date:.01/2512016 contractors to construct the project(Sce.7044,Business&Professions Code). 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 Code,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 of the z. I have and will maintain Worker's Compensation Insurance,as provided for California health&Safety Code,Sections 25505,25533,and 25534.I will by Section 3700 of the Labor Code,for time 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 3. I certify that in the performance of the work for which this permit is issued,I material.Additionally,should I use equipment cr eyes w �h emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay. Air alit, g=. strict District I will maintain compliance with the Cupertino 113 icipa de,Chapter 9.12 and Worker's Compensation laws o£California. If,after making this certificate of the health&Safoty Code,Se on �2 3,and 25534. 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 Owner or authorized agent: be deemed revoked. Date;01/25/2016 APPLICANT CERTIFICATION CONST C N LENDING A E 1 certify that l have read this application and state that the above information is I hereby affirm that there is s onstructibn 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,Civ 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 Cify in ARCILTECT'S DECLARATION consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the 1 understand my plans shall be used as public records, Cupertino Municipal Code,Section 9.18. Licensed Signature Date 01/25/2016 professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDINGDIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 AE GllPERTINa (408)777-3228•FAX(408)777-3333•_buildingCc--cupertino.ona [3 PROJECT ADDRESSgyp f i}� y APN# OWNEtt NAME ��//��•• .` �J� . 4319 p3 -.33?� f'1 ^" STREETADDRESS j S U ` t\ .� Y CITY,STATE, IP l u e.yf� CONTACT NAME Marjan Javanmard PHONE 65(x.477 6430 E-MAIL mjavanmard@solarcity.com STREETADDRESS391 Foster City Blvd CITY,STATE,ZIP Foster City, CA 944041 FAX ❑OWNER 11 OWNER-BUILDER ®OWNBR AGENT ❑ CONTRACTOR M CONTRACTOR AGENT ❑ ARCHITECT ❑13NCENEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME SolarCity Corporation LICENSENUMBER888104 LICENSE TYPE C 10 BUS.LIC If 2884 g� COMPANYNAMESolarCity Corporation B-MAIL mjavanmardsoIarcity.corn FAX 00 T� STRF,BTADDRESS391 Foster City Blvd CITY,STATE,ZIP.Foster City, CA 94404 P'40NE650.477.6430 ARCHITECTIENGINEER NAME LICENSE NUMI3ER BUS.LIC M COMPANY NAME WAIT, FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFJ}Or Duplex ❑ Multi-Fanlity PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO SOLARPANELS ❑ F.i.ECTRICVEHICLECHARGINGSTATION ❑ SOLAR WATER HEATING ❑ OTIIER: FORSOLARPANELS: NUMBBROFFANELS/UNITS: l KILOWATTS(COMIbIPRCIAL ONLY): I TOTAL VALUATION: ` oa DESCRIPTION OF WORK Installation 1 a- } rooftop flush mounted solar panel ., -M ) kW By my signature below,I certify to each of the following: I aI th, perty owner or authorized agent to act an the property oxner' Is application and the infornnation I have provided is correct. , ve €33d the Description of Work and verily it is acourato. I agree to comply with all applicable local ordinances and state laws relating to building const actio a ofze representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPL MENTAL 1NFORMATIQN1tEQUIRED OFFICE USE ONLY per, ❑ OVER-THE-COUNTER EXPRESS © STANDARD O a ❑ LARGE a ❑ 1,WOR PYApp_201 Ldoc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR--BUILDING DIVISION ADDRESS: 7481 ROLLINGDELL DR DATE: 01125/2016 REVIEWED BY: MELISSA APN: 359 32 011 BPH: B-2016-1249 *VALUATION: 1$6,500 "PERMIT TYPE: Building Permit PLAN CHECK TYPE Alteration 1 Repair PRIMARY SFD or Duplex PENTAMATION SOLAR-RES USE: PERMIT TYPE: WORK INSTALL 12 ROOF TOP FLUSH MOUNTED PV MODULES 3.12 k SCOPE Ww _. _ = = _ u: 1'Ic}in Check t'I rrrrf !'irw Che c l Z rr:.Pion Ctu:cA +eck Fermhc .lee: .'1Tttf}t'i. °r:,'ftei 1"t•'s'_ 1 Lec.Perri}tit 1 ce. t3:he .tk h.Irrsp3Li I cmler.l unib 1}t-T. Other i,ev.171a°p- r1e.:: 1 hw-,&.lrnj. F-ec: 1-10c. tmp; Pee, NOTE; This estimate does not Include fees clue to other Departments(i.a Planning,Public Works,Fire,Sanitary Sewer District, School District;etc. . These e-v are baseti ore the relinainar i4formation available and are only an estimate. Contact the De t or•addn'l info, FEE ITEMS CFee Resolution 1.1-053 E(f E-„( 7/.1113), FEE QTY/FEE MISC ITEMS Plan Check Fee: - $0.00 F771 # Alternative Energy System Suppl.PC Fee: a) Reg. Q OT Lfllus $0.00 $236.00 1PI-10TOYRES Photovoltaic System PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Lisp.Fee: Reg. Q OT Q 4 . hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C`Crrrsi�ut;lrftrt ire; Administrative Fee; Work Without Permit? 0 Yes ( No $0.00 Advanced PlanningFee: $0,00 Select a Non-Residential G D•tavelDo£:trtrrerrtatirsn Ftec'.s: Building or Structure Strong Motion Fee: 1BSEISMICn $0.85 Select an Administrative Item Bldg Stds Commission Fee 1BCBSC $1.001 1 _. . -- 'SUBTOTAliS $1.$5 $236.00 TOTAL FEE $237.$5 Revised: 01/0112016