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15060183CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20740 VALLEY GREEN DR CONTRACTOR: CUPERTINO ELECTRIC PERMIT NO: 15060183 INC OWNER'S NAME: CUPERTINO SI 30 LLC 1132 N 7TH ST I DATE ISSUED: 09/29/2015 I OWNER'S PHONE: 4086740481 ( SAN JOSE; CA 95112 1 PHONE NO: (408)991 -1000 1 C❑ LICENSED CONTRACTOR'S DECLARATION License Class Lie. # Ul (,,I Contractor Date 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. 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 sou cc �gulations per the Cupertino Municipal Code, Section 9.18. Signature Date � XA d ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL A 2500KVA TEMPORARY GENERATOR. LOCATION: C6 Sq. Ft Floor Area: I Valuation: $20000 APN Number: 32610047.20740 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ��� Date: n �l 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 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. agent: Date--0-1 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 950143255 CUPERTINO (408) 777-3228 •FAX (408) 777 -3333 • building(a�cupertino.org 1,�Obc)IB3 MISC ❑PLUMBING nWCHANICAL INELECTRICAL nMISCELi ANEOUS PROJECT ADDRESS 20740 Valley. Green Dr. APN # -e� 412 OWNE7, / PHONE ) E-MATL STREET ennuFCS- ra C STATE ZIP /: rq 'upertZIP CA 95014 CONTA�aTjN PF1gNI - 674 -0481 FAX nM@apple.com STREET�rie nfinite Loop ��`'Eupeffino, CA 95014 FAX ❑ OWNER © OWNER - BUILDER I_I OWNER AGENT EiCONTRACTOR 13 CONTRACTORAGENT ❑ ARCHITECT I-I ENGINEER. © DEVELOPER ❑ TM4ANT CONTRACTO NAME John Walters LICENSE NUMBER 174637 LICEN TYPE G10 BUSL # 697 "'ANIM ertino Electric, Inc. MAX john '468- 275 -6492 "EI IMIN. Seventh St. CITY, Jan $,rAfop se, CA 95112 o PHQp1E,- 593 -2066 ARCHITECT /ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME ' E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD., DUPLEX' ❑ MULTI - FAMILY BUILDING: CICOMMERCLALL PROJECT IN WILDLAND ❑ YES URBAN INTERFACEAREA. NO PROJECT IN FLOOD ZONE Q YES NO Is THE BLDG AN ❑ YES ETCHLEAHOME? A10 DESCRIPTION OF WORK Insta112500kVA temporary generator. TOTAL VALUATIO RECEIVED BY: By my signature below, I certify to each of the following: I air the property owner or authorized agent to act on the property owner's behalf 1 have read this application and the information I have prajided is correct.£=�I hap read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating t ildi�g con ctiorY I a th rize representatives of Cupertino to enter the above4dentified property for inspection pu4poses. Signature of ApplicantlAgent: l Date: 6 -17 -15 PLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY t~ 9 Ej W U a El OVER- THE - COUNTER ❑ EXPRESS STANDARD ❑ LARGE ❑ n�AaoR MEPMIsMpp 2011. doe revised 06121111 IM-7 CITY OF CUPERTINO FEE ESTIMATOR _ uTTTT.nT>\tr D1V1Q1n1V -. ADDRESS: 20740 Valley Green Dr DATE: 06/29 /2015 REVIEWED BY: Sean APN: BP *VALUATION: 1$20,000 "PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex Other Elec. Insp. 0.0 hrs $48.00 [PENTAMATION ERMIT TYPE: 1 REAP WORK INSTALL A 2500kVA TEMPORARY GENERATOR. SCOPE Fermi! APPLIANCE / EQUIP TYPE FEE ID i'r wlb. Pl i'l ('heck QTY UNITS BP FEES Elec. Permit Fee :-IIEPERMIT Generators 1BREMPOWER Other Elec. Insp. 0.0 hrs $48.00 1 # $179 Fermi! lnsj.3 Fee PME Unit Fee: $179.00 PME Permit Fee: $48.00 ("On"i""fruction TL,rx: T Administrative Fee: mDMIN V $45.00 Work Without Permit? 0 Yes (F) No $0.00 TOTALS: ,.:, .. 179.00 $ Strong Motion Fee: IBSEISMICR AM E: 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 hated an the nreliminary infarmatinn availahlo and tyro nnhv nn octimato_ f nntart tho Wont fnr add" °I infn_ FEE ITEMS (Fee Resolution 11 -053 E . 711/13) ti eO,,. / tc;n f:'lrf ck i'r wlb. Pl i'l ('heck Elec. Plan Check 0.0 hrs $0.00 1<rec,',. F'et °rr rt F'ee }'lirnb. 1'errnir Fee: Elec. Permit Fee :-IIEPERMIT { `" '' t lc,c • tn,sn. over P alb 7nsn. Other Elec. Insp. 0.0 hrs $48.00 /te< ?. i up- Fee: Phinib. hi3'j). Fee: L1,-C. &ypI Fee: AM E: 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 hated an the nreliminary infarmatinn availahlo and tyro nnhv nn octimato_ f nntart tho Wont fnr add" °I infn_ FEE ITEMS (Fee Resolution 11 -053 E . 711/13) FEE QTY/FEE MISC ITEMS Plan (.'he cA, Fee: .hipp ../ f.. PME Plan Check: $0.00 Fermi! lnsj.3 Fee PME Unit Fee: $179.00 PME Permit Fee: $48.00 ("On"i""fruction TL,rx: T Administrative Fee: mDMIN V $45.00 Work Without Permit? 0 Yes (F) No $0.00 A(Ata.nee d Phinnii7ts-' 1`e,es. Travel Documentation Fee: ITRAvDoC ^� $48.00 Strong Motion Fee: IBSEISMICR $2.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SLIBT.OfiA�$ $323.60 $0.00TcL FED, . $323.60 Revised 05/07/2015