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B-2016-2064 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2064 20337 VIA SAN MARINO CUPERTINO,CA 95014-6332(316 01 196) SUNRUN INSTALLATION SERVICES INC SAN LUIS OBISPO,CA 93401 OWNER'S NAME: WONG KIN MAN AND YEE MACY DATE iSSUED:06/02/2016 OWNER'S PHONE:408-612-8056 PHONE NO:(888)657-6527 LICENSED CONTRACTOR'S DECLARATION, BUILDING PERMIT INFO: License Class C-46 Lic.#750184 Contractor SUNRUN INSTALLATION SERVICES INC Date 06/30/2016 X BLDG _ELECT —PLUMB 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 license is in full force and effect. JOB DESCRIPTION: (N)20-PANEL ROOFMOUNTED PV SYSTEM(5.3kW) I hereby affirm under penalty of perjury one of the following two 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. I have and will maintain.Worker's Compensation Insurance,as provided for by 1' Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$12000.00 APPLICANT CERTIFICATION 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 16 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 316 Ol 196 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT'ISSU CE OR Additionally,the applicant understands and will comply with all non-point source regulationWthepertino icipal Code,Section 9.18. 180 DAYS FROM LAST CALLED IN CTION. SignatureDate /26 /2016 Issued by:ALEX VALLELIJNGA i t -- Date:06/02/20.16 OWNER--BUILDER DE A ATION l I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofmg material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the.work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:6/2/2016 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&SafetyJC 'ons 05 533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent APPLICANT CERTIFICATION Date:6/2/2016 l certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 6/2/2016 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(aDcupertino.orq [:]NEW CONSTRUCTION ❑ ADDITION ALTERA�TyON/TI REVISION /DEFERRED ORIGINAL PER MIT# PROJECT ADDRESS ® c)I IS fn OWNER NAME ,{ � \e�� r'l.r� •S ' PHONEOs+' �tV�t Cr- VvvT E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTACT N _ m _ PHONE/,V.9®Zm0 E STREET ADDRESS CITY,STATE,ZIP FAX 1:1 OWNER ❑ OWNER-BUII.DER yyy❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT, a CONTRACTOR NAMESon LICENSE LICENSE B A BUS.LIC# COMPANY NAME EMAIL (�C l (� FAX ET ADD$�S!`-1l = k� V�i� k CI T?i ` A/-\- c l 1 E ZIPPH(J ll Z"t J"QclONE I ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS �- CITY,STATE,ZIP PHONE DESCRIPTION OF WORK y.�« 1LJ \/ So(I(`, g �o � g L�LJ d �j EXISTING USE PROPOSED USE CONSTR-TYPE #STORIES USE TYPE 'OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA; AREA NET AREA BATHROOM KITCHEN - OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKITORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YESEI ' TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NOAGO By my signature below,I certify to each of the following: I am the property owner or authorized ag nt act on e property owner's behalf. I have rcfad this application and the information I have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin u es fives of Cupertino to enter the above-identified property for inspection purposes. 4 Signature of Applicant/Agent Date: SUPPLEMENTAL INFORMATION REQUIRED PT AN cxi i KTYr> rio,IrnresLlr New SFD or Multifamily dwellings: Apply for demolition permit for ❑=QyER T1DrmT>R BI7II bING 1 iAn z >w existing building(s). Demolition permit is required prior to issuance of building x permit for new building. ❑,`Exp ss � PIAN ING FLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �,wgArzs fonn if any Hazardous Materials are being used as part of this project. � LARGE`>„ � � ❑ FIRE DEPT _Copy.of Planning Approval Letter or Meeting with Planning prior tosNrrArxY SEWER-nlsTRicT submittal of Building Pen-nit application. Q ENVIRONMENTAL HEALTH BldgApp_2011.doc Devised 06121111 U , y J. mum ILE �i y, COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION I< 10300 TORRE AVENUE CUPEjRTINO,CA 95014-3255 13 (408)777-3228• FAX(408)777-3333-)W ilding.Rog.pert no.ora PURPOSI This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access.for inspections are required. O1JNMU L INFORl ATION 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,CHC Section 8-314 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 ALA\RIA CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X bedroom(s) On every level of a dwelling emit including basements X X ji Within each sleeping.room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel burning appiliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with; CDC 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, aharm(s)may be solely battery operated. In existing dwelling,units;alarms are permitted to be solely battery operated where repairs or al':terafions do not result in ffie removal of wall aild ceilu-tg.finishes or there is no access by means of attic,b:aserne-amt ar crawl•' space.Refer to CIBC Section 1"314 and CBIC Sections 90.7.2.11.4 and 420.6•.2.An electrical permni t is.requrred.for alms arwhicll must be couzected to the building wiring. As owner of the above-referenced property,I hereby certify that tlae alarm(s)referenced above has/have been installed lin accordance with the manufacturer's instructions and in compliance with the CaliforniaBu ld'ung• and Calrfunlia.ResidentialCodes.The°alarms:have been tested aild are operational,as of the date signed below.. I ha e readsand al wee to com;l w. f e fermis anal`conditions;©f ffiis sfafemenk m -.. aI�i . s( :hat : te: Si"natftre .;; e ..................... Z, WATER-CONSERVING 'PLUMBING FIXTURES I OWNER 'CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building a( cupertino.orq„ �c dress ��_�3 � �o,°``� .�--✓ G2�.-.,tea 1. Is your real property a registered historical site? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of fonn. ,-No Go to Question 2. 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. El The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. uJ =iNo Go to Question 3. 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. j"o Go to Question 4. 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. – `AYes 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.. 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 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 I 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 plurnbing 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 pl bing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's SignatuCe; f Date: '7`i Upon completing and signing this Certificate,please rd-turn k to the Building Division in order to final your building permit. SB4072015.doc revised 08126115