15090202CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7875 CREEKLINE DR
CONTRACTOR:. REC SOLAR, INC.
OWNER'S NAME: QU JING AND ZHAO 11NG
775 FIERO LN STE 200
OWNER'S PHONE: 4082033557
SAN LUIS OBISPO, CA 93401
LICENSED CONTRACTOR'S DECLARATION
License Class L' Li.. #_ 7Sb
Contracto to}
I hereb rm 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:
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.
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.
Signatur Date stJd t
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:
�. 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 d
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
PERMIT NO: 15090202
DATE ISSUED: 09/30/2015
PHONE NO: (888)657-6527
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL Q
INSTALL 14 ROOF TOP, FLUSH MOUNTED PV MODULES,
3.85KW. UPGRADE (E) ELECTRICAL PANEL TO 125 AMPS,
SAME LOCATON
Sq. Ft Floor Area: Valuation: $8000
APN Number: 36217050.00 IOccupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
ED INSPECTION.
Issued b
_. \D tte:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTiNO (408) 777-3228 • FAX (408) 777-3333 building(a cupertino.ora
PT7App_2011.doerevised 03116111
PROJECT ADDRESS _
APN #
OWNER NAME
�j PHONE o s E-MAIL
STREET ADDRESS
CITY, STATE, ZIP FAX
CONTACT NAME PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP FAX
❑ OWNER ❑ OWNER -BUILDER ❑ ONX ERAGENT ❑ CON'T'RACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSENUMBER
e
S
PE B
LICENSE TTd—
�$
BUS. LIC 9
COMPANY NAME
FAX
STREET ADDRESS
ATE, ZIP l — � a �,�g
®
PHONE zf� ��
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC 99
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
PROJECT IN WILDLAND
PROTECT IN
STRUCTURE: ❑ Commercial
URBAN INTERFACE AREA ❑ Yesk ❑ NO
FLOOD ZONE ❑ Yes ❑ NO
0%Gr1PANELS
1 ❑ ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER BEATING
❑ OTHER:
F R SOLAR PANELS: NUMBER OF PANELSMNTITS:IQLOWATTS (CSA R °
TOTAL VALUATION:
DESCRIPTION OF WORK.
(i try -
K_ A
yT
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the proerW_ et s behal r h� is
application and the information I have provided i correct. I have read the Description of Work and verify it is accur aVy with an applicable local
ordinances and state laws relating to building t tion. I esentatives of Cupertino to enter the above -id ified p apeerty for inspection purposes.
Signature ofApplicant/A- —
Date: I I
SUPPLEMENTAL INFORMATION REQUIRED
�'�r�
W
YER�TH1<COIiNTE?
410 I MOM Ko
PT7App_2011.doerevised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 7875 CREEKLINE DR DATE: 09/30/2015 REVIEWED BY: MELISSA
APN: 362 21 050 BP#:
• 0 011-? *VALUATION: $8,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
USE ARY SFD or Duplex PENTAMATION
PERMIT TYPE: SOLAR -RES
WORK INSTALL 14 ROOF TOP FLUSH MOUNTED_ PV MODULES 3.85kW. UPGRADE E ELECTRICAL ,
SCOPE I PANEL TO 125 AMPS, SAME LOCATON
1:1ech. flan (..'heck Phim .. Plan Clock Elec. Plan Check 0.0 hrs $0.00
-Wee'.71. Permit / eye: Plumb. P erinit Fee: Elect. Permit Fee: 1EPERMIT
E i1 cr 11r1 i ta..Iris�>. tJiher Pluinb .Iayp. Other Elec. Insp.0.0 hrs $48.00
flet°h. Is pr Fee: Plumb. Is Is Fel: Ilea Insp. Fee:
NOTE. Thic rrctimaty dnnc lrni itlrluda fnoc dun in —fl.— ll
Dictrirt_ Otr-)
FEE ITEMS (Fee Resolution 11-053 E f 711113
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
#
$236.00
Alternative Energy System
IPHOTOVRES Photovoltaic System
Suppl. PC Fee: (j) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
=amps
$48.00
Electrical
IBELEC200 Services
Permit Fee:
$0.00
Suppl. Insp. Fee: Reg. 0 OT
T 0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
(.1011struclion .l a* .X
Administrative Fee: IADMIN
$45.00
0
G
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICR
$1.04
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
TOTAL
$143.041
$284.00
TOTALEE:9
$427.04
Revised: 07/02/2015