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B-2016-2136CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS:. CONTRACTOR: PERMIT NO: B-2016-2136 1527 POPPY WAY CUPERTINO, CA 95014-5306 (366 15 029) GREEN POWER INSTALLERS INC SANTA CRUZ, CA 95060 OWNER'S NAME: CHATTERJEE NILANJAN AND BIJOYA DATE ISSUED: 06/15/2016 OWNER'S PHONE: 408-615-1558 PHONE NO: 408-368-6133 LICENSED D ONTRACTOR'c DECLARATION BUILDING PERMIT INFO: License Class C-1 0 Lic. #952145 Contractor GREEN POWER INSTALLERS INCDate 09/30/2016 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 hereby affirm under penalty of perjury one of the following two declarations: (N) 12 -PANEL ROOF -MOUNTED PV SYSTEM (3,42kW) i. 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, J 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: $12000.00. APPLICANT CERTIMICATION certify that I have read this application and state that the above information is correct. I agree t6 comply with all city and county ordinances APN Number: Occupancy Type: and, state laws relating to building construction, and hereby authorize 36615 029 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. Additionally, the appli ant lerstands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations rt pertino Municipal Code, Section 9.18. 180 DAYS FROM LAST Ef INSPECTION. - Sign Lure � Date 6/15/2016 Issued by: Alex Vallelunea 1 Date: 06/15/2016 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 i. 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) z. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 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 performance of the work for which this permitis issued. HAZARDOUS Code, for the HAZARDOUS MATERIALS DISCI Compensation, p Y Section of p t1RE 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, 2553, and 25534. 1 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 1 hick emit hazardous 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 thlCu rhno 11�iuucipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions ofthe the Health & S Cho 05 25533, 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: 6/15/2016--- I /1 2 1 1 certify that I have read this application and state that the above information is CONSTRUCTION L ING A EN J Y 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 Q.) to enter upon the above mentionedproperty 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 /615/2016 Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 CUPERTI NO (408) 777-3228 • FAX (408) 777-3333 WuildingCW-cupertino ora 2 G t (0 PROJECT ADDRESS 1 5-C APN # ClC l �� ' t✓� OWNER NAME r ► V i CA r/l C CIle, lele PHONE J Lwz e I' I S E-MAIL STREET ADDRESS i & CITY, STATE, ZIP \J L n. FAX CONTACT NAME PHONE / (( /fin// %� % (t 2 &MAIL STREET ADDRESS !i 6` p � Yl'R CITY, STATE, ZIP S� 4 i .� l� � I,GI� FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ :CONTRACTOR ❑: CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAM PLICENSE NUMBE4 �Z y /, r- LICENSE TYPE BUS. LIC I�r'� 2 COMPANYNAME/ G€ / �f LICE? ' (J v tr°E''.Q % V • �l eL�-. E-MAIL FAX. STREET ADDRESSIf/,d �r4in fl 1f_VF�� CITY, STATE, CC �p �� jP PHONE2136 f 7.3 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF I fs SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO SOLAR PANELS❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELSIUNITSi KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: Ss �3 O DESCRIPTION OF WORK c � 2 Y% `R YVI-0 I_kA 4-1 �1,o Wktt5 By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owners behalf. I have read this application and the information I have provided is correp I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bui i n. I authorize representatives of Cupertino to enter the above -identified property for in�pepurposes. Signature of Applicant/Agent: Date: �j� `� SUPPLEMENTAL INFORMATION REOUIRED, PVApp_2011.doc revised 03116111 SMOKEICAMONWO'NOXID ALARMS 0 E' 'RTIFICIATE OF'GOMPLIAUGE WN R GE C,'OMMUNITY:DEVEL,'GPMBNT�DEPARTMENT - UILDING DIVISION 10300 TORRE AVENUE - CUP8IRTUNJO, CA 95014-3255 (408) 777-3228 ® FAX x(408) 777-3833 - bu,11ftmAcu, P.ertino.orq PtIRPOSE TI-iis affidavit is a. self -certification for the installation of 91 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. GEINtRAL Ilii] ORMATION 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 R,314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarm's and/or Carbon Monoxide Alarms be installed in the following locations: 0 AREA SMOKE ALARM CO ALARM Outside of each -separate sleeping area in the immediate vicinity of the beditcrom X X Ott, ever y level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms an not reqttired, in dwellings which do i Lot contain fuel -burning appliances and that donathave anattached garage. Carbon monoxide alarms combined with, smoke alarms sliall comply with,, C'8.0 Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: in dwelling units with not co i =ercialpower supply, alarm(s}m-ayb-e solely battery operated In existing dwelling units,, alarms are permitted to be solely battery operated where repairs, or alterabioil& do not, rest -It iii the rern-oval, of wall and ceiling fin -is -hes, or there is no access by means of attqc,baseyncent or crawl', space. Refer to, CRC Seebion, 8344 and CBC Sections 907.2.11.4 and 4201.6.2. An electrical permit is, required for a1armswhich must beeoiurtected to, the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed inn, accordance wiffi, thme. rnmanuf actux, er's instructions and in compliance with the CalUfurmia B, uaildha and Ca., Rforrua, Residentiail, Codes,. The alarms, have been tested and are, op, eiratiorial, as of the date signed below. WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE F _'L E, COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE . CUPERTINO, CA 95014-3255 d .l-rvc Owner Name f 1 � � C 777-3228, FAX (408) 777-3333 buildin-gO-cupertino.org 4,6 rk -,-_ �c Permit Nod) — Z-01 3C Address d� 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 form. 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 beenprovided to the Building Division. _ Skip the rest of the form and sign bottom of form. 0. 96 No Go to Question 3. 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. op No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 19947 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. 01 Yes 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.. 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 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,$umbing fixtures comply with the requirements as indicated in the table on the following page. / ___.._.... Owner or Owner Agent's Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08126115