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B-2016-2114 CITY OF CPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2114 20846 GREENLEAF DR CUPERTINO,CA 95014-1819(326 30 1 1) SOLARCITY CORPORATION SAN MATEO,CA 94402 OWNER'S NAME: PARVATHANENI BHASKARAAND SUNA�I)AA DATE ISSUED:06/13/2016 OWNER'S PHONE:408-406-0790 II PHONE NO:(650)963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-46 Lic.#888104 Contractor SOLARCITY CORPORATION Date 1213112016 X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapte 9(commencing with Section 7000)of Division 3 of the Business&Professions Co a and that my license is in full force and effect. JOB DESCRIPTION: (1)16 PANEL ROOF-MOUNTED PV SYSTEM(4.16 kW) 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-insµre for Worker's REV 41-ADDING 200 AMP SUBPANEL 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 ection 3700 of the Labor Code,for the performance of th0 work for which this permit is issued. Sq.Ft Floor Area: Valuation:$9000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: 326 information is correct.I agree to comply with all city and county ordinances 326 30 171 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF P �t�TED T ISSUANCE OR Additionally,th applicant understands and will comply with all on-point source regula o per the Cupertino Municipal Code,Section 918. 1$0 DAYS FROM LA A INSPECTION. Signat- 0A Date 6 2 2016 Issued by:Alex Vallelunea I Date:06/13/2016 OWNER-BUILDERDECLA I I hereby affirm that I am exe t fro the Contractor's License Law for one of the RE ROOFS: following two reasons: I All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 1,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 int I nded or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. 1,as owner of the property,am exclusively contracting wi licensed Signature of Applicant: contractors to construct the project(Sce.7044,Business&Professions Code). Date:6/27/2016 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-inslue for Worker's Compensation,as provided for by Section 3700 of the Labo Code,for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. 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 permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this ermit 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 makin this certificate of will maintain compliance with t Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation 1provisions of the the Health&Safe C d ,Sections 25505 2553 and 2 553 4. Labor Code,I must forthwith comply with such provisions r this permit shall be deemed revoked. Owner or authorized agent: J2" I— APPLICANT CERTIFICATION Date:6/27/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENA N Y correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a constructio lending a ncy for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued( ec.3097, iv 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 Pity 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 Code,Section 9.18. I 1 understand my plans shall be used as public records. Licensed Signature Date 6/27/2016 Professional CONSTRUCTION PERMIT APPLICATION 00xv COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•LUPERTINO,CA 95014-3255 I (408)777-3228• FAX(408)777-3333•building a CUPERTINO cugertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ Al TERATION/TI L�&IISION/DEFERRED ORIGINAL.PERIv11T#__ PROJECT ADDRESS 2_O V q W /'ree4,1 le- D-: / APN# �/7 / „ _ I OWNERNAME �i `/ ,r, PO�� rST1I E-MAILn 1'1 ' l� `STREET ADDRESS P FAX CONTACT NAMEqqqq ,��,�I1Q��G PH NE �� E-MAIL ---- — STREET ADDRESS G.{ t `Sbb/�y. CITY, OD, El OWNER El OWNER-BUILDER 11 O��11STATE, I AX '---- �WNEERAGENT ACON'1RACTOR ❑CONTRACTOR AGENT ❑ ARCHI CT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAM) Sb 6,, CrfX ICENSE NUMB LIC NSE T P BUS.LIC i� COMPANY NAME E-MAIL. FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME ----� I iCENSE NUMBER -- --- - BUS.LIC P --- COMPANY NAME - - I EMAIL---- ------�_-•---�-- FAX ------. STREET ADDRESS CITY,STATE,ZIP I PHONE DESCRIPTION OF WORK :20 �o A ------_-__- V I � d'`�a� • EXISTING USE PROPOSED USE CONSTR.T7 #STORIES - USE TYPE, OCC. SQ-FT. VALUATION($) EXISTG NEW FLOOR •DEMO .TOTAL AREA AREA AREA NET AREA . I. BATHROOM KITCHEN ' OTHER REMODELAREA REMODELAREA 'REMODEL�R A PORCH AREA DECK AREA7777�CK/PORCH AREA GAkA iEAREA: DETACH❑ATTACH #DWELLING UNITS: ISA SECOND UNrr C YES SECOND STORY E]YES BEINGADDED? E]NO ADDiTIO{? []NO /. PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BI�I DG AN E]YES RECE �._ TOTAL VALUATION: PLANNING APPL# FIND PLANNING APPROVAL LETTER EICHLERII HOME? ❑NO By my signature below,I certify to each of the following: 1 am the l6roperty owner or ant lorize4 agenU6 act o the property owner's behalf. I have read this application and the information I have ro ded is correct. 11 1Id the Description of Work and verify itis (curate. I agree q comply with all applicable local ordinances and state laws relating b ldi s cti e representatives of Cupertino to enter th a e-de 'fie •rop for inspection purposes. Signature of Applicant/Agent:_ _ -_ Date:SUPPLEMENTALINFORMAT N QUID Pinx'cHECK .SPE ROUrixcsir _ New SFD or Multifamily dwellings: App TUN moliti n permit for ❑' ovER-THE-COUNTER ❑ BUILDING PLAN REVIEW - existing i permit i re un for to issuance of building g g( ) P 9 permit for new building. ❑ EXPREss ❑ `PiANNING`$I AN_REV1Ew, _Commercial Bldgs: Provide a completed Hazardous Mat rials Disclosure 0`,.STANDARD ❑, PUBLIC,WORKS form if any Hazardous Materials are being used as part of thisproject. [] LARGE FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to El submittal of Building Permit application. I MAJOR ❑ sAxrraRYSERERbtsTRtCT. ❑'ENVIRONMENTAL.HEALTH " IlaBldgApp_2011.doc revise((06121/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2114 20846 GREENLEAF DR CUPERTINO,CA 95014-1819(326 30 171) SOLARCITY CORPORATION SAN MATEO,CA 94402 OWNER'S NAME: PARVATHANENI BHASKARAAND SUNANDAA DATE ISSUED:06/13/2016 OWNER'S PHONE:408-406-0790 PHONE NO:(650)477-6430 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CCQ Lic.#888104 Contractor SOLARCITY CORPORATION Date 12/31/2016 X BLDG . ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: (I)16 PANEL ROOF-MOUNTED PV SYSTEM(4.16 kV) 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. 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. Sq.Ft Floor Area: Valuation:$9000.00 APPLICANT CERTMCATION 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 26 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 326 30 171 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 liabilitie,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in c sequ nce of the granting of this permit. WITHIN 180 DAYS OF PERMIT SUANCE OR Additionally,the applicant under and a will comply with all non-point source regulations per the Cu rtin icipal Code,Section 9.18. 180 DAYS FROM LAST C L SPECTION. Signature Date 6/13/2016 Issued by:Alex Vallelung_a Date:06/13/2016 OWNER-BUILDER DECLARATION 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 roofing material being installed.If a roof is t. I,as owner of the propert};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:6/13/2016 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 permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 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 shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air ualitvydV)ganagement District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino nicipal�de,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 505 5 33,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized anent:/ APPLICANT CERTIFICATION Date:6/13/2016 / I certify that I have read this application and state that the above information is CONS7RU IO LENDING NDINAGE t 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 e.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 Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 6/13/2016 Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTIN® (408)777-3228•FAX(408)777-3333•buildingQcupertino.org PROJECT ADDRESS g %EL J(0 /�Y � C APN# OWNERNAME �Y\��„ 11�Y P V �k PHOI� Q! — E-MAIL o�Y atz i W STREET ADDRESS_ C� � ^r CITY, STATE, y\© _A CONTACT NAME Marjan Javanmard �f PH NE650.477.6430 LE-MAIL mjavanmard@solarcity.com STREET ADDRESS 391 Foster City Blvd CITY,STATE,ZIP Foster City, CA 94404 FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR N CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICE Corporation LICENSE NUMBER 888104 LICENSE TYPE BUS.LIC COMPANY NAME SolarCity Corporation E-MAIL mjjavanmard@solarcity.com FAx UU 'T STREETADDRESS391 Foster City Blvd CITY,STATE,ZIP Foster City, CA 94404 PHGNE650.477.6430 ARCHITECT/ENGINEER NAME LICENSE NUMBER l �s BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRU URE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ NO FLOOD ZONE ❑ Yes ❑ No SOLAR PANELS I ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATION: ,j DESCRIPTION OF WORK Installation ( i G ) rooftop flush mounted solar panel (�'- t (,) kW 17 RECEIVEDBM By my signature below,I certify to each of the following: I am thep'perry er or authorized agent to act on the prope o is ehalf. I have read this application and the information I have provided is correct. I have rod the Peg6ription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I au onr�-e e entatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: /� Date: 0 SUPPLEMENT,94NFORMATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER H ❑ EXPRESS U v ❑ STANDARD 5 U a ❑ LARGE a, ❑ MAJOR PVApp_2011.doe revised 03/16/11 SMOKE i .CARBON: N �1D:E L1AR,,M OWNER C'E"FICATE Of COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION U � 10300 TORRE AVENUE-CUP'ERTINO,CA 95014-3255 (408)777-3228 'FAX(408)777-3333 bufldng(a�cuperkino.org i:� �WR Tifti { �1 PURPOSP 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. GV,N'MAIL 1N-V RMATION, Pxisthig single4arnily 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 8314 and CBC Sections 907.2.1:1.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SN40K-,E ALAfZU C0 AtMf Outside of each separate sleeping area in the immediate vicinity of the X X bedrooms) On every level of a dwedlin&unit including basements X X Within each.sleeping.room X Carbon Monoxide alarms ar-e not required in dwellings which do not contain fuel burning appliances z nd that do not Halve an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CDC Section 420.6 wad shall be approved by the Office of the State Fire Mliarshal. Power Supply:Indwelling.units with,no comm, ercial power supply,alarm(s)may be solely battery op rated. In existi2%g dwelI'ing a nits alarms are permitted to be solely battery operated where:repairs or alterafio s,do not result in the removal of wall aild cell ing finishes or, there is ino access by means of attic,b�aseinent or crawl space.Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and.420.6.2.An electrical perimt;isrequ'ped,for afarms wliich must be connected to the building wirhlg. As owner of the above-referenced property,I hereby certify that tlae alarm(s)referenced above has/have been installed in accordaizce with the manufacturers instructions and in compliance with the California Bu.ld iag, and Califonzra Residential Codes..71 l e alarms have been tested and are operational`, as of the date signed below„ ;. l.F have readjand a r.ee fo cora with t(ie:Germs=and conditions of this,stfiement rate -.OA1 r - T _. ...... V Si nature ......... ..Lic: .... .:.. WATER-CONSERVING PLUMBING FIXTURES 5 IV 19 OWNER CERTIFICATE OF COMPLIANCE F-18WWR COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO I 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 qpg)7 3228-FAX(408)777-3333 build ingftupertino.org Owner Name_ h ,*-c(R.� _ lr`�� `� rt' Permit Nod �I Address n (3 � 1. Is your real property a'registered historical site? ❑ Yes Civil Code Sections 1101.1through 1101.8 do not apply. Skip the rest of the form and sign bottom of Form. ❑V'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. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. LI No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1.101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of Form. J No 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 orm. Li 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 andsign bottom of form.. 5. Ple se 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 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 improveme ts). 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. Owner or Owner Agent's Signature, Date: Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15