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15100242CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10200 BYERLY CT STE E OWNER'S NAME: DANIEL ARUL S AND MIRIAM CONTRACTOR: SOLARCITY PERMIT NO: 15100242 K TRUSTEE 3055 CLEARVIEW WAY -DATE ISSUED: 10/30/2015 OWNER'S PHONE:. 4084442045 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class ® Lic. # 'Install p� (22) rooftop flush mounted solar panel (5.72 KW); Install (N)125 amp Contractor I t Date � 0 f �j subpanel. 1 hereby affirm that I am licensed un er 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 Sq. Ft Floor Area: Valuation: $12500 Section 3700 of the Labor Code, for the performance of the wok for which this permit is issued.APN Number: 34212088,00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above informationis correct. I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter upon the above mentioned WITFIIN 180 DAYS OF PERMIT ISSUANCE OR property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additiona , th applicant understands and will comply Issued by: .� Date: with all non-point source regulaf ns p r e Cupertino Municipal Code, Section 9.18. Signature °• Date (i (5 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 ® OWNER-BUILDER DECLARATION inspection. I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: L as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professions Code) L as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will declarations: maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I have and will maintain a Certificate of Consent to self-insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the material'. Additionally, shouldI use equipment or devices which emit hazardous performance of the work for which this permit is issued. air contaminants as defined by the Bay Area Air Qu. lity Management District I will maintain compliance with the Capertin un' i al Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 533 , d 25534. Section 3700 of the Labor Code, for the performance of the work for which this Permit is issued. Owner or authorized agent: /� Date: t C' I certify that in the performance of the work for which this permit is issued', I shall %f 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply I understand my plans shall be used as public records. with all non-point' source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date ALTERNATIVE ENERGY PERMIT APPLICATION E V E L!� F � =,T�, N _0P4E_'NT A� --Ahn RIO 009� a. PROJECT ADDRESS P) L APN 9 �2 OWNER NAME ONE MAIL STREET ADDRESS JCA 6IP STATE, fl FAX oloc.) 1 CONTACT ""Marjan Javanmard PHONE 650.477.6430 E-MAIL mjavanmard@solarcity.com STREET ADDREss391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 944041 FAX ❑ OWNER 11 O%VNER-BUILDER El OWNER AGENT n CONTRACTOR CONTRACTOR AGENT F1 ARCHITECT El ENGINEER 1:1 Dl:.VF;.T.OPFR 11 TFNANT CONTRACTORNAIME SolarCity Corporation LICENSE NUMBER 888104 I LIC ENSE TYPE C 10 BUS. LIC BUS. US LC 928840 COMPANY NAME SolarCity Corporation "'mjavanmard@solarcity.com -om FAx STREET ADDREss391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 4*04 PHONE PHONE650.477.6430 ARCHITECT/ENGfNEER NAME LICENSE NUMBER BUS. LIC 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF STD or Duplex El Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: El Commercial URBAN INTERFACE AREA 0 Yes E] No FLOOD ZONE El Yes El No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION El SOLAR WATER HEATING E0 THER: O FOR SOLAR PANELS: NUMBER OFPANELS[UNITS: f KILOWATTS (COMMERCIAL ONLY): 5 z2_ TOTAL VALUATION DESCRIPTION OF WORK 1 Installation rooftopflush mounted solar panel (5 ��:) kW By my signature below, I certify to each of the following: lam application and the information I have provided is correct. I hai ordinances and state laws relating to building construction. I 4� Signature of Applicant/Agent: INFORMATION RECEIVED BY: -.11 or authorized agent to act on the property owner's behalf. I ha read t)is on of Work and verify it is accurate. I agree to comply with all app TIca ble local es of Cupertino to enter the above -identified property for inspection purposes. Date: 01310 1 i 5 RED OFFICE USE ONLY 0 El OVER -TUE -COUNTER �4 E-❑ EXPRESS U El STANDARD U El LARGE ❑ MAJOR P V4pp_2 011. do c revised 03116111 -1 CITY OF CUPERTINO FFF FQT1MA9rn12 — RITTT 1lrATf'1 Trx77c+rd�%xT ADDRESS: 10200 Byerly Ct FEE i ♦ iAJi DATE: 10/30/2015 V 1 \ REVIEWED BY: Phuong 11al APN: 342-12-088 BP#: *VALUATION: $12,500 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair UHIEIVIARY or Duplex __[SFD PENTAMATION Suppl. PC Fee: (E) Reg. 0 OT PERMIT TYPE: SOLAR -RE WORK Install 22 rooftop flush mounted solar panel5.72 K • Install N 125 amp. subanel. SCOPE $0.00 125 amps Electrical $48.00 1 IBELEC200 Services _........... __. Afech. Plart Check 7'himb. Platt Cheek Elee. Plan Check 0.0 1 hrs $0.00 ilecJr. t'efrnit Fee: Phimh. Pertrrt Fee: Elec. Permit Fee: IEPERMIT Other llech, Insp. Chher Piurnb In,sn. Other Elec. Insp. 0,0 hrs $48.00 :1,lectz Insp. Fee: 1 hinih Insp. Fee: E/ c. layp. Fee: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School Vrstrect, etc). !hese fees are based on the Prelimina information available and are only an estimate. Contact the De t or addn'l in o FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Alternative Energy System $236.00 IPHoTOVREs Photovoltaic System Suppl. PC Fee: (E) Reg. 0 OT 0 - 01 hrs $0.00 PME Plan Check: $0.00 125 amps Electrical $48.00 1 IBELEC200 Services Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. 0 OT p 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 C:'onsiruch.on Tax: Administrative Fee: IADMIN $45.00 0 Work Without Permit? O Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure i Travel Documentation Fee: ITRA VDOC $48.00 Strom Motion Fee: IBSEISMICR $1.63 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC 1 $1.00 _.SA T $143.63 $284.00 TTL F1i1 +' $427.63 Revised: 10/01/2015 CUPERTINO Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFicxm OF COMPL@ANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (40 8) 777-3228 - FAX (408) 777-3333 • building(aD-cupertino.org Aflil-k Permit No. Address 8 02-o o V ,,,or , &.k C kAU A, _,1 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. CI"No Go to Question 2. .. ll- 2z�r 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the properly or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. rNo Go to Question 3.Q(f? 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Al Q�No Go to Question 4.)DV4- 4. ,Is your real property built and available for use or occupancy on or before January 1, 1994? (`_ �L ❑ 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. Skip the rest of the form and sign bottom of form. is IrYes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Check one of the three following statements and sign bottom of form..,p f- 5. e se check ONE of the following: L% Pl2My property is a single family residential real property. 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- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential 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-compliant 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. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirernents, and that the w t conserving p mbing f tures comply with the requirements as indicated in the table on the followina Daae. - ( r_,� A % ( +' 2Ll - l %Ir- Owner or Owner Agent'sSignatum-,_.J Date=, J II Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15 CUPERTIMO PURPOSE SMOKE 0 CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 o FAX (408) 777-3333 o buildingCakupertino.orq a�I Ili () 2.7 � Cr r¢,¢.���: n ra �+`I m1�nc�d:�: Z - PERMIT CANNOT RE FINALED AND COMPLETE, D UNTIL THIS CERTII+ICATE IIAS SEEN oSif4NE - RE7 I RNLD TO TiFi1C: BUILDING DIWISI®N 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 N.. 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 Buildu1g and -California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and conditions of this statement w 060 ; o¢rOwner=AgenYs)•Na I -2u Ci?hffac &Al me: Si' nq:ture...................................................................`Lim?.................................... 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