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B-2016-2003
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2003 10416 CHERRY TREE LN CUPERTINO,CA 95014-2006(316 33 046) SOLARCITY CORPORATION SAN MATEO,CA 94402 OWNER'S NAME: UBALE ANIL W AND SONVANE ANURADHA U TRUSTEE DATE ISSUED:05/24/2016 OWNER'S PHONE:408-307-7752 PHONE NO:(650)963-4722 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class WARM-AIR HEATING VENTILATING AND AIR-CONDITIONING Lic.#888104 X BLDG —ELECT —PLUMB Contractor SOLARCITY CORPORATION Date 12/31/2016 _MECH X RESIDENTIAL_COMMERCIAL 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 DESCRIPTION: license is in full force and effect. (N) 16-PANEL ROOF-MOUNTED PV SYSTEM(4.16KW) I hereby affirm under penalty of perjury one of the following two declarations: t. 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 Sq.Ft Floor Area: Valuation:$9000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct.I agree to comply with all city and county ordinances 31633 046 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 PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities,judgments,costs,and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue against said City in co equence of the granting of this permit. Additionally,the applicant unders d d will comply with all non-point 180 DAYS FROM LAST CA LE NSPECTION. source regulations per the Cupe ino nicipal Code,Section 9.18. Issued by:Alex Vallelunea Signature Date 5/24/2016 Date:05/24/2016 \ I d OWNER-BUi R DECLARATION 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 inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature ofApplicant: 2. I,as owner of the property,am exclusively contracting with licensed Date:5/24/2016 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 of the 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 3. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or de ces which emit hazardous air contaminants as defined by the Bay Area Air Q ity nagement District I shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cupertino Mui ipal e,Chapter 9.12 and Worker'sCompensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 2 `05,25 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:5/24/2016 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 to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address 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 5/24/2016 ALTERNATIVE ENERGY PERMIT APPLICATION lis COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 90300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildina(7R.Cupertino.o PROJECT ADDRESS l®ef I � C? I_C_Y� TT�e. L CinC APN# OWNERNAME vA V` So n'slc&n PHO� A {OU JCJ tSo� E-MAIL STREET ADDRESS ��0 j I f (2 t t CITY,STA {\� r O (14 FAX CONTACT NAME Marjan Javanmard PH ONE650.477.6J430 E-MAIL mjavanmard@solarcity.com STREET ADDRESS 391 Foster City Blvd CITY,STATE,ZIP Foster City, CA 94404 FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑®CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMESOIarCity Corporation LICENSENUMBER888104 LICENSE TYPE C10 BUS.LIC 42884-4 COMPANYNAMESOIarCity Corporation E-MAILmjavanmard@solarcity.com FAX STREET ADDRESS 391 Foster City Blvd CITY,STATE,ZIP Foster City, CA 94404 PHONE 650.),5-®1 j 3 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF CdSFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN JS CTURE: ❑ Commercial URBAN INTERFACE AREA LlYes ❑ NO FLOOD ZONE ❑ Yes ❑ No OLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION FOSOLAR 1-1 WATER HEATING OTHER: FORSOLARPANELS. NUMBER OFPANELS/UNITS: 1 KILOWATTS(COMMERCIAL ONLY): (�, 1 TOTAL VALUATION: ©©O Oo DESCRIPTION OF WORK Installation (« ) rooftop flush mounted solar panel q•k G ) kW ,4 RECEIVED BY: �L/ By my signature below,I certify to each of the following: I a e rope wner or authorized agent to act on the pros owner's behalf. I have read this application and the information I have provided is correct. I ve re t escription of Worlc and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. authorize epresentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: - Date: 0,5/, SUPS' EMEL\I I`AL INFORMATION REQUIRED OFrICE USE ONLY X OVER-THE-COUNTER ❑ EXPRESS ❑ STANDARD U U a ❑ LARGE *EAa ❑ MAJOR PVApp_2011.doc revised 03/16/11 OF ;{ Y OWNER C.E, COMMUNITY'DEVELORMENT DEPARTMENT-BUILDING DIVISION TfMC 10300 TORR'E AVENUE•OUPP-RTINO,CA 95014-3255 (408)777-3228• FAX.(408)777-3333, buildinq(�cupertino orq , �4 PURPOSIE 'J:7.•is 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. GEN MAL INVORMATION 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 $1.0001.0€,CIBC Section 8314 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 ALA m Outside of each separate sleeping area in the immediate vicinity of the 5 X bedrooms) On ever' level of a dwellin unit includinbasements X _ X Within each sleeping in; roorti X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do nat have an attached garage. Carbon monoxide alarms combined with ssrnoke alarms shall conTly with CBC Sectio71420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling units with no commercial power supely, alarm(s)may be solely battery operated. In existing_dwelling units;alarrms are permitted to be solely battery operated where repairs or alteratiais do not result in the removal of wall and veil iag finishes or there is rto access by means of attic;basernentt or craw 11 space.Refer to CRC Section R3114 and CBC Sections 90?�.2..1T.4 and 420.6.2.Ail electrical perrrut is required for alarins which,must be connected to the building wiriaag. As owner of the above-referenced property,I hereby certify that the alarm(s)'referenced above has/have been installed i1 accordance with the rmanufact urer s instructions maid in,compliance with the California.Buildii.q. and Califon2 a Residential.Codes.The alarmshave been tested aild are operational', as of the date signed below. l have react,and a vee to com;.l Yr with the;terms and conditions of this statement r— s( tCtre ..... 6�D6l p /.... si"i5�at Via... ... iLte `Date FIL WATER-CONSERVING PLUMBING FIXTURES 6 b /6 OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUP`ERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 i (408)777-3228•FAX(408)777-3333• buildin cu ertino.or. _ +�� > 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. X No Go to Question 2. 0 1�10�/ 210 (9 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the forn and sign bottom of form. K No Go to Question 3. 6 ; 0 /2-616 3. Is water service permanently disconnected for your building? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 019 No Go to Question 4. 6e 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ 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. Ej9 Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 0�Q 6�, 6 A2At 6 5. Please check ONE of the following: / / My 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 t 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). El My property is a commercial real properly. 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 requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. 019 e- [—Owner or Owner Agent's Signature: f Date: 0 Upon completing and signing this Certificate,please return it to the Building Division in order to final your building p rmit. SB40 7 2015.doe revised 08126/15