15100081CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21929 OAKDELL PL
CONTRACTOR: iSOLARCITY
PERMIT NO: 15100081
OWNER'S NAME: CHANDLER TIMOTHY R F AND ZAMOONNA
3055 CLEARVIEi
WAY
DATE ISSUED: 10/12/2015
OWNER'S PHONE: 6508772337
SAN MATEO, CA'
94402
PHONE NO: (650) 638-1028
Ed LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPT
ON: RESIDENTIAL E] COMMERCIAL
INSTALL (N) ROO
TOP MOUNTED SOLAR PV - 18 PANELS
License Class e Lie. # [
(4.68 KW)
� f
Contractor —a t (n n Date_ l / 1 �L/ 15
I
I hereby affirm that I am licens 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:
Sq. Ft Floor Areafi
Valuation: $10000
i. I have and will maintain a certificate of consent to self -insure for Worker's
APN Number: 32439001.00
Occupancy Type:
Compensation, as provided for by Section 3700 of the Labor Code, for the
a 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.
PERMIT
EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATION
WITHIN
lS
180 DAYS OF PERMIT ISSUANCE OR
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
180 DA
,,,�Y,
FROM LAST CALLED INSP CT ON.
�6r
upon the above mentioned property for inspection purposes. (We) agree to save
Issued by:
IX'0
Date:
indemnify and keep harmless the.'City ol�Cupertino against liabilities, judgments,
p
costs, and expenses whichit,accrue gamst said City in consequence of the
this Aonally the
granting of permit. applicant understands and will comply withRE-ROOFS:
Cupertino Code, Section 9.18.
all non-pointsourcereguie Municipal
All roofs shall be inspected
prior to any roofing material being installed. If a roof is
Signature F '' Date ' (
installed without fiFst
obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Appli
Dant: Date:
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
ALL ROOF
COVERINGS TO BE CLASS "A" OR BETTER
the following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
HAZARDOUS MATERIALS DISCLOSURE
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
I have read the hardous
materials requirements under Chapter 6.95 of the
2. 1, as owner of the property, am exclusively contracting with licensed contractors to
California Health&
compliance with the
Safety Code, Sections 25505, 25533, and 25534. I will maintain
Cupertino Municipal Code, Chapter 9.12 and the Health &
construct the project (Sec.7044, Business & Professions Code).
Safety Code, Section
25532(a) should I store or handle hazardous material.
I hereby affirm under penalty of perjury one of the following three declarations:
for Worker's
Additionally, sho
contaminants as defined
Id I use equipment or devices which emit hazardous air
by the Bay Area Air Quality Management District I will
1. I have and will maintain a Certificate of Consent to self -insure
maintain compliance
oth the Cupertino Municipal Code, Chapter 9.12 and the
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Health & SafetyC
o It, See ti ns 25505, 25533, and 25534.
1c 1
2. I have and will maintain Worker's Compensation Insurance, as provided for by
for this
Owner or th Y"i
e7i 'ge
Date:
Section 3700 of the Labor Code, for the performance of the work which
{�
permit is issued.
3. I certify that in the performance of the work for which this permit is issued, I shall
CONSTRUCTION LENDING AGENCY
not employ any person in any manner so as to become subject to the Worker's
I hereby affirm that
there is construction lending agency for the performance of work's
Compensation laws of California. If, after making this certificate of exemption, I
for which this permit
is issued (Sec. 3097, Civ C.)
become subject to the Worker's Compensation provisions of the Labor Code, I
Lender's Name
must forthwith comply with such provisions or this permit shall be deemed
revoked.
Lender's Address!
I
APPLICANT CERTIFICATION
ARCHITECT'S DECLARATION
I certify that I have read this application and state that the above information is
I understand my plans
shall be used as public records.
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
Licensed Profes4nai
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.
I
Signature Date
t
i
ALTERNATIVE ENERGY PERMIT
PPLICATION
'1 1 '1-li Nvl. tip^ E� {.Y 3 3
lE �.. 41
\z;` y, ./4i `
{ t'Sr
'.. } --iii ` TC # 1 { 'l F '., '�
,AE
`
. I
CUPERTINO
I
8pep
PROJECT ADDRESS fG '3� i
APN k
_
OWNERNAME > �,/�
i l�/dd C-,(
PHONE
2
V_3R
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
llai,.jan 1avanmard PHONB 650 477 J6430
CONTACT NAME Marjan
VV Y� �/ �!
JZIP
&MAIL mjavanmard@solarciiy.com
STREET ADDRESS9'
391 Foster City Blvd
I
CITY, STATE,
Foster
City, CA 94404
FAX
i
❑ OWNER ❑. O%INER-BUILDER ❑�+OWNERAGENT ❑ CONTRACTOR IN CONTRACTOR AGENT j
❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAIVIESOIai�Clty Corporation LICENSE NUMBER 888104
LD 6
LICENSE TYPE BUS.LICk�4440
!! VV 84
pp�'a y+(C3➢
COMPANY NAME SolarCity Corporation
E-MAILE-M.AILmiavanmard@solarcity.com
F
STREETADDRESS391 Foster City Blvd
CITY, STATE, ZIPFosteti
City, CA 94404
PHGNE650.477.6430
ARCHITECT/ENGtNEER NADIE
LICENSE NUMBER
BUS. BUS. LIC 9
COMPANY NAMEE-MAIL
I
FAX
STREET ADDRESS CITY, STATE, ZIP
PHONE
USE OF dSFD or Duplex ❑ Multi-Family PROJECT IN WILDLANDi
PROJECT IN
CommercialURBAN INTERFACE AREA E]��es
❑ No FLOOD ZONE ❑ Yes ❑ No
STRUCTURE: ❑
r
SOLAR PANELS
❑ ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER
BEATING
❑ OTHER:
FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: $ KILOWATTS (COMMERCIAL 014
IY): '
TOTAL VALUATION' '
DESCRIPTION OF WORK
I
Installation ( If ) rooftop flush mounted
solar panel (q kW
I
RECEIVED B I $ g d
By my signature below, I certify to each of the following: I am the property orvpeg or authorized agent
application and the information I have provided is correct. I have read tk/e Deson lion of Work and v
to act on the property owner's behalf. I have read this
'rlfy itis accurate. I agree to comply with all applicable local
erty for inspection purposes.
ordinances and state laws relating to building construction. I authorizp're resp atives of Cupertino to
enter the above-identified pro
Signature of Applicant/Agent:
Date: L� � I - 1'5
SUPPLEMENTAL 1NFQRMATION REQUIRED
OFFICE USE ONLY
— -- --
- --- _
I
U
OVER -TIiE COUNTER
❑ ESPR_SS
F
F
;y
ElsTaNDAizD
U
❑ LARGE..
❑ ivlAroR
PVApp 2011.doc revised 03116/11
i
CITY OF CUPERTINO I
FEE ESTIMATOR — RITILDING DIVI4TON
_' ADDRESS: 21929 Oakdell Place
DATE: 10/1/2016
REVIEWED BY: PAUL
A APN: 326 39 001
BP#: j
VALUATION:
j$10,000
YPERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
PENTAMATION SOLAR -RES
PERMIT TYPE:
WORK
Install N rooftop mounted solar PV - 18 paneIs 4.68
SCOPE
PME Plan Check:
ifecer. I'trrrr (.:'heck I'hwib. Man Chec'Ti I Ic . ,I'hzn Check
tfcch. Pe:ntdi' 1-ee: P wnb. PF'.'oni7 Fee: Eke. Permit Fee:
Ofher hlech. 7ruP.
011ie' Pi2tt12b Imp.
}thee' L>Iee. Insp.
A, eJnsptee-
PiIj/ee: AIUMiT �'
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
Dls..:..s __ 1 Tbr'nntart tho vont for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 711/13)
FEE
QTY/FE
MISC ITEMS
Plan Check Fee:
$0.00
#1
$236.00
Alternative Energy System
ipHOTOVRES Photovoltaic System
Suppl. PC Fee: (E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. Cl OT
0,0
h r s
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
F-1
dinin.is'tratiLee Fee:
0
0
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
j
Select a Non -Residential
Building or Structure
E)
0
19
I r iwilel Documentevion Fees:
Strong Motion .Fee: IBSEISMICx
$1.30
j
Select an Administrative Item
B1dp, Stds Commission Fee: IBCBSC
$1.00
SI7BT pTALS.
_. .
$2.30
$236.00
TOTAL �'EE
$238.30
Keviseu: ,urvirGv iu
SMOKE I CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORREAVENLIE - CUPERTINO, CA 95014-3255
(+408) 7n-3= -.FAX (408)`77 t- 333 • h�n�tiirrd�r tttato.��
Address
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 INFORMA'T'ION
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
d,'( nnn nn e'177r' C__44 __ ujt of - C....L— ON711 11 C ......7 Ann
tiTSL VV:JV, uti�. �J�L4Vii SWR Gbh Loi t -i ei. ��iiVi G�1ems-7.. A {. ._A r_
E__ lVliW4ld�!''....t,.....
LwJ __.{-1��LQ �itsJ Vi
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroo s)
X
tCO
X
On eM 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 vvith smoke alarms shall comply with
C33C 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 W77.2.11,4 and 420.6.2. An electrical permit is required for
ala=s 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 Cal itorfua rcesideneiai codes.—the alatn s have been rested and are operadunal, as or crie date signed.
below.
Smoke and CO form. doc revised 0311811.4
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
commuklmy nr-vn OPMPHT nr-r)a1ZTkACKtT . 01 ttl nlalf-- MW136ir"m
10300 TORRE AVENUE - CUPtRTINO, CA 95014-3255
CUPERTIN
(40 7 7-3228.- FAX (408) 777-3333 - buildinqOgupertino.ord
Owner Name La All- 000ij
Permit No.
Addr6ssll,-,
tole
cv e
Is your real property a registered historical site?
11 Yes Civil Code Sections 1101.1 through 1101,8 do not apply:..Skip the rest of the forin and sign bottom of form.
[9 -,No Go,to Question 2,
'Does your -real propertyhave a' licensed plumber certifying that, due to the age or configuration of thaproperty or its
Dlumbine. installation of
b Yes Civil Code Sections -1101.1" through 1101:8- do not apply,
0 The licensed plumber's -certification has been provided to the : Building Division.
,Skip the test of the form and sign bottom of form,
M -_No Go to Question 3.
11-_ Is water service Permanently disconnected f6r, vour building?
U Yes Civil. Code Sections 1101.1 through 1101.8. do not apply. Skip the rest of the -form and sign bottom of form.
[�-No Go to Question 4.=foAr'-
4, is your real property built and available for use or occupancy on or before January ,l, 1994? f A- C f -124 16-'
0 No 'My real, property is built and available for use or occupancy after larinary 1 1004
Civil Code Sections 1.101.1 through 1101.5 do'not apply. Skip'the rest of the form and sign bottom -of form.
54- Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections .1101.1• ougi 1101.8 apply. Check" cane ofthe :three fallowing statements and sign
bottom of form.,
:Please check ONE of the'followine:
09 My property is,a Eingle-fnmily,residenfial real'property. SeeCivil Code Section 1101.4.
On and -after January 1,'2 - 014, 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 watcn-conserving; Plumbing- fixtures (regardless of whether
property .undergoes. alteratipns or unpTovements).
• My property is ii- nit(Itifain i ly resid6nrial real property, See Civil Code,-S:ection 1101.5.
On and after January 1, 2014, specified building alterations or.improv6merits'shall require non- compliant
plumbing, fixtures to be replaced witb:%vater-consbri ing plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing
ng fixtures throughout the building (regardless of whether property undergoes alterations or
improvements),
• My property is acommercial ;real property. See Civil Code Section 1101
kill and.. a -itt:r January.1, 20.14, specified building, alterations or improvements shall requirenon- compliant,
plumbing fixtures to be replaced with water -conserving piuiribing fixtures.
On or before. January 1, 2019, all non-cbmpliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures, throughout the building (regardless of whether property undergoes alterations or improvements).
1, as -the owner or owner's agent of this property, certify under penalty of pedury that non-compliant plumbinp- fixtures will be
1 cy in fixtures iacea P70or to Cow sPucihed above wifn water -conserving -plumbing fix res in accordance with Civil Code Sections 1101. 1
through 1101..8, the qwTeritCaliforniaFlumbin9 Code and Qali.fomia Green Building Standards Code, and manufacturer's
.
installation requirements, and that the Nvater-conserving plumbing fixtures comply with the requirements as indicated in the,
table on the followi - ng
g
page /17
,Owner or Owner Agents Sign ,111-41 1114 Date: i7,T1FAv1-
7
,SR407 2015.doe rel"lsed 08126/'15
1. If the existing plumbing fixture water usage/flow rate is equal to. or lower than the figure shown., it is not required to be upgraded.
SB407 2015.doe revised 08126115
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbin Fixture!
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usa a/Flow Rate
Ix-,ure i yp.e
Water Usage
Z015 CPC Ch. 4
2013 CPC Ch. 4
20.1.3'QPC Ch. 4
/Flow. Rate
2013 CALGreen. Div: 4.3
2013 CALGreen Div. 4:3
2013 CALGreen�Div. 5.3
Single -.Family
Multi=Family
Commercial
Residential
Residential
Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets. 1.28 gallons/flush effective flush volume (the posite,
i
_cont
UZtir'a a 1"" i volul�l a UT uav- reoijc;eu nusnes ane 0-1.6 ma Iiusnf)
Urinals
Exceed 1.0
0.5 gallonslflush.
Gallonsiflush
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 Showerheads.
(A hand-held shower is considered a showerhead.)
Fnr mo iltinla.ehnwarhRarlc cmmiinn nna chnuiar tkm i•nmhinarl flntiai rn4e.nf all
show.erheads and%rather 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.
Faucets —
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
1.per.minuteg60 psi;
psi
miimum 0:$ -gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
77,i,,; L _
V60 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
00. psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2,
minute 60 osi. and must
onllons ner minute n
@
default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi.
the above are unavailable,
Where.faucets meeting
aerators or other means
the above are .
'
i110 uc' UOVU tv OWIM vc
Uiiavdildula, dClctlUlS'U(
reduction,
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to. or lower than the figure shown., it is not required to be upgraded.
SB407 2015.doe revised 08126115
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