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B-2016-2206 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2206 10370 PALO VISTA RD CUPERTINO,CA 95014-2708(357 02 05 1) SLINGSHOT POWER INC LOS ALTOS,CA 94022 OWNER'S NAME: PALLIPURAM GERARD AND MELINKERI I WEDITA DATE ISSUED:06/23/2016 OWNER'S PHONE:408-393-4159 PHONE NO:(650)308-9055 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10.C-46 Lic.#984488 Contractor SLINGSHOT POWER INC Date 06/30/2017 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 Cod and that my license is in full force and effect. JOB DESCRIPTION: (N)15 PANEL ROOF-MOUNTED PV SYSTEM(4.3kW) I hereby affirm under penalty of perjury one of the following two eclarations: 1. I have and will maintain a certificate of consent to self-ins a 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. z. I have and will maintain Worker's Compensation Insurance,as provided for by ?ecti3700 of the Labor Code,for the performance of th work for which this on ermit is issued. Sq.Ft Floor Area: Valuation:$15390.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the abov information is correct.I agree to comply with all city and county rdinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 357 02 051 representatives of this city to enter upon the above mentioned p operty for inspection purposes. (We)agree to save indemnify and keep h rmless the City of Cupertino against liabilities,judgments,costs,and expe ses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of his permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all on-point source regulations per the Cupertino Municipal Code,Section 918. 180 DAYS FROM LAST FAVL�ED SPECTION. Signature /� �� —r Date 6/23/2016 Issued by:Alex Vallelunga Date:06/23/2016 a G� . v OWNER-BUIL DER DECLARATION I hereby affirm that I am exempt from the Contractor's License L iw 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 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 wid licensed Signature ofApplicant: contractors to construct the project(Sec.7044,Business& rofessions Code). Date:6/23/2016 I hereby affirm under penalty of perjury one of the following thre declarations: AL •ROOF COVERINGS TO BE CLASS"A"OR BETTER t. I have and will maintain a Certificate of Consent to self-in a 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 Insuranc ,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 th work for which this California Health&Safety Code,Sections 25505,25533,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 ermit 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 Quality Management District I Worker's Compensation laws of California. If,after makin g this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensatio provisions of the the Health&Safety Code,Sections 25505,25533,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:6/23/2016 1 certify that I have read this application and state that the abov information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances an state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize represen atives 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 purp ses. (V11e)agree Lender's Name to save indemnify and keep harmless the City of Cupertino agai st liabilities, judgments,costs,and expenses which may accrue against saic 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 Cu 3ertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date Professional ALTERNATIV ENERGY PERMIT APPLICATION REMI M.6 COViIVIUNIiYDEVELo PMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVEN F- CUPERTINO, CA 95014-3255 Al= CUPERTIhlO (408)777-3228 • FAX 1408)777-3333•buildina0noeriino.org PROJECT ADDR.ESS \Q��b j P3N R —4O�- V 3 OW1 cRN.S1,4E UVV� �Cov' V a ' " I PHOhE ©CJ- [� -7�J� c-A4p.IL STR ETADDPESS jo51C) �)q(e` 0=5 I CITY, STT ZIP CONTACT NAME Q PHON'` STP E7rDDR:SS ! �t� I CITY,STATE,SZIP FA-x ❑07, R ❑ OWN.=RAGZNT CO1\FFR_SCTOR 'E .""CTORAGHN ❑ ARC=1-CT ❑E.NGD=—R ❑ DP\-_LOPER ❑ i=X-ANT CCOON1.iTPRfN1,CY?NOARhN2E1 1„E LICENSE CENS'�LTHER �G c(^,^ �I9US.LIC'��! f � I B-hCUL LTC od I FAX 1 STREET ADDRESS �� //►/�A �� CITY,STATE,ZIP/ ®_5, fT I PHONE A.RCh7TECT/ENGI-EER.NA1,:E I LICENSE N'U1r4BER BUS.LIC CON"PANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family I PROJECT IN WILDLAN`D PROJECT IN STRUCTURE: ❑ COMI-nercial URBAN INir.RFACE AREA ❑ Yes Cl No FLOOD ZONE ❑ Yes ❑ No e SOLAR PANELS I ❑ ELECTP.IC VEHICLE CI'-',R. STATION E) SOLAR 1�'ATEP I'£.STING El OTHER: r OR S071_R PANELS: NUA!BER Or`?A viLSlUNITS: 1 KILOWATTS(COII4?-=CIAL ONLY): TOTAL VALUATION: /�2(t�40 DESCRIPTION OF WORK tD,00 �- s ,--• By my sienar Te below,I ce rif�r to each of the folloWine: I am the property owner or authorized agent to act or.the proper wner's b Half. I have reed this application and the information I have provided is correct. I ave read the Description of -Work and verity it is accurate. I a_ree to comply With all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cuperino to enter the above-identified property for inspection purposes. 5i 4� F 6�za/j6 nature of Applicant. e�;t: I�—'s D�te: SUPPLEMENTAL INF RMATION REQUIRED - 21 � -� OL 2EIsCOTJI�TER# aux Ld RGA_ hIAJOR -- PV.4pp_2011.doc revised 03/16/11 SMOKE /,CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ,CUP MEQ 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333 e building(a)cupertino.org Permit No. %o(6, zte) Address 1122 70 PhL-v Vt siw #of Alarms Smoke: Carbon Monoxide- PERMIT CA TOT BE EINALED AND C6MPLEZED=I7NTI ,THIS CERTIFICATE " < HSS PTEA TSE BUILD G UI� ()NF '�^ �s��...,. ,,...,,.,.�, ,....,.,. .,:..:< .xe, _.;.::. ,^..�,;.., ,,...�.: �•..s„rr .. . .,, z:;sty;r, .,.. PURPOSE 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 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 ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X 1 Within each sleeping room L X J 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 8314 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 Building and California Residential Codes.The alarms have been tested and are operational, as of the date signed below. have read and agree to comp! with the terms and conditions of this statement Owner(or Owner Agent's)Name: GUIZAR)f ALL 1 PV ,t1-M Si nature....... ....Date: t/.1.4 Contractor Name: Signature...................................................................Lic.#......................................Date: ................... Smoke and COform.docrevised 0311811.4 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333 buildingCcDcupertino.orq Owner Name � tZ/1R Pt PUC?ek7�n Permit No. �� Address /0'970 P& ViS3-71- 9b CyPeRTI NPS CA J_"5 7D1 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. K No Go to Question 2. 1 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. No 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. R 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 form. MI/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.. 5. Please check ONE of the following: 19"'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 plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: Date: � 14 !,6 Upon completing and signing this CertifIcate,please return it to the Building Division in order to final your building permit. SB40 7 2 015.doc revised 08126115