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07040217- PUB T y >' a) y d O N Q1 a Q) U O f m u tpi�. CL ¢ _ u u o cn z Q o CD N j 9 a, l J i WLLI m j D] Ld f O Q id o i iC3 UCD a o Cc CD CD _ _ a'a 7 s; i s LO a w W ElO Iu a ! o CC) a_ LIDc m 2 Li U 3 i1�1w I, : 4, +O (N - -._ x ; COL 4 W D c LU LO U y Lo Ll m Q 0 y , _, U a �, , ,� a > LL- fo F� J O 211 � Q ii h ti U i x 15 15 70 0 I � w a a a CL I Z a N O O 0CD � a `y � °' J o a O W M a a Ij kA LLI 0OL LO ._..._ n J mro ! j. -1ry - ��a. LL I Cil Q j w i 'O CD Co C) {fes j of I `s N ti N �_ �D J ! LO 777 O fff ..j O 'f V ,., n C �CD U N O LN { O W Q O M CL m v uo Lo Cn U o J t '��` a a 1 aJ !{ C ro y x 7 Q) OL E i o x xy � x g 1�fJ 'n O I I- y1 COL ro � COL N kA E x� Z a� '' U v OwC 2 C) t in EL " Z Z y U � a1 L Q It aY U 1., (1 al U 0 u 'a U E s al E 2 (U a`l al ti a O :o cn zu o L W ,`• N o 'A Q Q) a`l Q1 a`l CL a- O Q Ul U O a_ O ICA a, u� _ al C �, CITY OF CUPERTINO BUILDING DIVISION PERN111 CLi. GTC/ INFtQR1A: BUILDING AD RESS: PERMIT NO. 2218c4 VIA CAMINO CT HORIZON ENERGY SYSTEMS 07040217 OWNER'S NAME: PERMIT ISSUE DATE BERRY HAROLD E AND BEVERLY M 440 SALMAR AVE 05/09/2007 PHONE: SANITARY NO. CONTROL NO. (408) 395-9060 ARCHITECr/BNGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o p LICENSED CONTRACTOR'S DECLARATION V i= I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description Z„�, with Section 70W)of Division 3 ofthe Business and Professions Code,and my Gcensc is SOLAR PANE L a in full force and effect. y? License Class /S- C-1 G Lic.N l.,p Date_ 5' `1 -- 7 Contractor '� ARCHITECTS DECLAf0 J ce< 1 undcrstand my plans shall be used as public records yU Licensed Professional Professional y< OWNER-BUILDER DECLARATION a I hereby affirm that 1 am exempt from the Contractors License Law for the m O0 structurefollowing reason.(Section 7(131.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure Q prior to its issuance,also requires the applicant for such permit to rile a signed statement z<' that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter9 Sq.Ft,Floor Area Valuation t-a (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $36940 F that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of �]Number Occupancy Type not more than five hundred dollars($500). 32 646009 A8U 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered rorsafc(Sec,7044,Business -Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered forsale.if, however,the building or improvement is sold within one year of completion,the owner. builder will have the burden of proving that he did not build or improve for purpose or sale.). Q I,as owner of the property,am exclusively contracting with licensed contactors to construct the project(Sec.7044,Business and Professions Code:)The Contactors Li- cense Law docs not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. Q 1 am exempt under Sec .B&P C for this reason Owner— Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. (9 1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number arc: Cartier._S Ta'rI" = Polity No.: h• c'52.- CERTIF LATE OFEXEMPr1GN FROM WORKERS' COMPENSATION INSURANCE (Ibis section need not he completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance or the work for which this permit is issued,1 shall not , employ any person in any manner so as to become subject to the Workers'Compensation Laws or California Date Applicant NOTICE TO APPLICANT:If,after making this Cenificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Z forthwith comply with such provisions or this permit shall be deemed revoked. O CONSTRUCTION LENDING AGENCY -+�--� I hereby affirm that there is z construction lending agency for the performance of li the work,for whicb this permit is issued(See.3097,Civ.C.) QLender's Name Lcndees Address j Q I certify that 1 have read this application and state that the above information is 1a correct.I agree to comply with all city and county ordinances and state laws relating to J building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. y L1. (We)agree to save,indemnify and keep harmless the City of Cupertino against C4 liabilities,judgments,costs and expenses which may in any way accrue against said City j Z in consequence of the granting of this permit. ► APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULA yS. S—1 °7 Re-roofs Signature of Ap icant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? Ycs Mo All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? 1]Yes �KNo I have read the hazardous materials requirements under Chapter 6.95 of the Califor• nia Health&Safety Code,Sections 25505,25533 and 2.5534.1 understand that ifthe building docs net currently have a tenant,that it is my responsibility to notify the occupant of the O requirements which m t be mel prior to issuance of aCertificate of Occupancy. sign urs of Applicant Date S,-I�O7 All roof coverings to be Class"B"or better T n,,. *CITY OF CUPERTIN SOLAR PANE CITCUPE�TINO PERMIT APPLICATION FORM APN # 062 Date: y^ Z ©7 Building Address: vo Owner's Name: Phone #: 44r,-, 1-0 �'3��2� - 7 Contractor: Phone: License#: �o�r2Qr� ��N�/< 6 `1 S`1Sr�s nioG ® Z`j83 9 Conntact: Phone: Cupertino Business License#: Building Pen-nit Info: Bldg ❑ G2 ,;) , `Tv SyS')�r� Job Description: -SoLp,z IPA4,P 81--Y�� Residential Commercial ❑ Cost of Project: Qty. if AppRable Fee ID Fee Description F.ee.-Group. -= --SOLARRES -- -Residential Solar Permit-- -- BUILDT_NG _ Business License BENERGY Energy BUILDING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BSEISMICOM Seismic Commercial BUILDING • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 0- Of Fax(408) 777-3333 CUPEkTINO Building Department JOB ADDRESS: PERMIT # ��70�a1 -2 V) nr-b Cyd-, OWNER'S NAME: M,4" 9� A'KFj PHONE # GENERAL CONTRACTOR za67FAX # 3 9 s -679— I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile er Contractor Signature Date