B-2016-2275 CITY OF C PERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2275
21478 METEOR DR CUPERTINO,CA 95014-1325(326-44 002) SUNRUN INC
SAN FRANCISCO,CA
94105
OWNER'S NAME: BHANDARE SHRIKRISHNA AND KANCHAN DATE ISSUED:07/08/2016
OWNER'S PHONE:408-204-5175 PHONE NO:(415)580-6900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class 1 Lic,#969975
Contractor SUNRUN INC Date 02/28/2018 X BLDG _ELECT _PLUMB
MECH X RESIDENTIAL_COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 91I(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
ROOF MOUNTED SOLAR SYSTEM(15 MODULES)(3.9 W).
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-insurel 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.
V
1 have and will maintain Worker's Compensation Insurance,as provided for by
cction 3700,of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$10000.00
APPLICANT CERTIFICATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 326 44 002
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 ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per the Cup rtino nici al ode,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatureq(� Date 7/8/16 Issued by: SEAN HATCH _
Date:07/08/2016
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)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Pr'fessions Code). Date:718116
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 1 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.
Health&Safety Code,Section 25532(a)should I store or handle hazardous
s. I certify that in the performance of the work for which this permit is issued,I
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 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&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
�"Oes
APPLICANT CERTIFICATION Date:7/8/16
I 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
Code,Section 9.18. I 1 understand my plans shall be used as public records.
Licensed
Signature Date 7/8/16 Professional
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333-building(a)cugertino.ora
PROJECT ADDRESS I / M 01 /�, n �/`L APN#
OWNER NAME l`� ` ' ` (J `(— PHONE J \V "E--MA"IlL
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STREET ADDRESS CITY,STATE,ZIP FF
CONTACT NAME PHONE `( E-MAIL
STREET ADDRESS CITY,STATE,ZIP (•� W FAX
OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ��CONTRIACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMESr ^(�j LICEWE NUMBER LICENSE TYRE BUS.LIC# Z�
COMPANY NAME V`/` �Gv E-MAIL `' FAX
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TREET ADDRESS CITY TATE,ZIP HO
cx� 24n%h(2 i� n �o CA G s r 31 069-Z 3-OC-1 I t
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
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COMPANY NAME i E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
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USE OFSFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN
STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes No FLOOD ZONE ❑ Yes [(NO
i
SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER:
FOR SOLAR PANELS. NUMBER OF PANELSIUNITS: �KILOWATTS
(COMMERCIAL ONLY): TOTAL VALUATION:,,
DESCRIPTION OF WORK
0 SA qrrz CO
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RECEIVED BY +`
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatin �;rion. Ithorise representatives of Cupertino to enter the above-identified property r inspection purposes.
Signature of Applicant/Agent. Dater
SUPPLEMENTAL INFORMATION REQUIRED oFFici',us>L ONLY,
S ` � OVER THE COUNTER
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DocuSign Envelope ID:A01E568D-BD88-4036-B216-5A5621AF0873
SMOKE / CARBON MONOXIDE ALARNMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINQ 10300 TORRE AVENUE CUPERTINO,CA 95014-3255
(408)777-3228-'FAX(408)777-3333-building(akuaertino,org
Permit No '�'��
Address p# #°of Alarms Smoke: 6 Carbon Monoxide: 2.
PERMIT CANNOT BE FINALED AMD COMPLETED UNTIL THIS CERTIFICATE
HASPEEN, (ZM AND RET 7RN U TO THE BUILI3ING IVISION
PURPOSE
This:affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314,2013CBC Sections 420.6 and 907.111.2 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 vitality of the X X
bedrooin(s)'
On ever level of a dwelling unit inludhn basements X X
within each sleeping room X
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)maybe 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 trach=l
space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for
alarms which must be connected to the buildingwiring.,
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.
1 have.read and agree to complywith the terms and conditions of this statement
Owner(or Owner Agents)Name: noausigned by: 7/18/2016 7 3::37 Pf
4t Si nater .. 27��a
Date:
contractor``N(a}me: 2625FBOFcic435. �)
Sinatur ......... ......... ........, .........Lic.#.......C! Q;...................Date:
Sinoke and CO foriti.doc evised 0,3118114'
DocuSign Envelope ID:A01E568D-BD88-4036-B216-5A5621AF0873'
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY iDEVELOPMENT DEPARTMENT•BUILDING(DIVISION
CIJE'EftTIhiC7 10300 1 ORRE AVENUE• CIJPERTINO,CA 95014-3255
(408)777=3228•FAX A08)777-3333-building(d,)cuAertlho ora
Owner Name Permit No. D (
Address ( t s
1. Is your real properly a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 110 1.8do not apply. Skip the rest.of the form and sign bottom of form.
Z, 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
plumbiing,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 Buildingpivision.
Skip the rest of the form and sign bottom of form.
o 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..
o Go to Question 4.
3
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No Ivey 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 Test of the form and sign bottom of form.
Yes Ml y 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 sip
bottom of form..
5 Please check ONE of the following:.
My property is a single-family resid6ntial real property. See Civil Code Section 1101.4.
--Ori 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 ofwhether propertyundergoes alterations or improvements)..
I,as the owner or owner's agent of this property;certify under penalty of perjury that noxi-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. Docusignea by:
Owner or Owner Agent's Signature. ?tCt�? G� anima ' Date. M P
-Upon completing and signing this gI g tWF�%Iffe-return it to the Building Division in order to final your building permit.
3B4072015.doc revised 08126115