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B-2016-2176 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMPI'NO:B-2016-2176 10919 FESTIVAL DR CUPERTINO,CA 95014-4161(362 17 021) SUNWORK RENEWABLE ENERGY PROJECTS MILPITAS,CA 95035 OWNER'S NAME: SUBRAMANIAN MAHADEVAN AND RATNASAMY DATE ISSUED:06/21/2016 SUBHASH OWNER'S PHONE:408-203-6580 PHONE NO:(650)520-9918 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-46 Lic.#920732 Contractor SUNWORK RENEWABLE ENERGY PROJECTS Date 08/31/2016 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 Code and that my license is in fullforce and effect. JOB DESCRIPTION: (N) 15 PANEL ROOF-MOUNTED PV SYSTEM(4.2 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-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. 16/1-4 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:$13250.00 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 62 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 362 17 021 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 Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 6/21/2016 Issued by:AbbyAvende Date:06/21/2016 OWNER-BUILDER DECLARATION I hereby affirm that am exempt from the Contractor's License Law for one of the RF.-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. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:6/21/2016 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 a. 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 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: APPLICANT CERTIFICATION Date:6/21/2016 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 andlstate 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 purpo es. (We)agree Lender's(dame 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 6/21/2016 Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(a_cupertino.M cuP�RrrNo )--Zot(s-Z l PROJECT ADDRESS /O . DRI v f- APN# OWNERNAME /'7A(114DEVA1v SUIS PHONE 91- 03-6s-g0 E-MAIL /�/1/`��N/✓4N 2 STREET ADDRESS L pR VE CITY,STATE ZIP FAX CONTACT NAME RR Y�N VOEL PHONE i LOS��L�sS�g 9/I E-MAIL�j R Yfi N Sd�/k'�RK, Olt G STREET ADDRESS 4f,7 7 vAt t,E y why CITY, `T�/IPPS 7 9S o3 S FAX ❑OWNER ❑ OwNER-BUB.DER . ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHrrECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME tQxvB'e—N V4-k LICENSE NUMB R LICENSE TYPE BUS.LIC# _ � 7 3 2 G— 6 %20 73 Z COMPANY NAME E-MAIL FAX SUAII-A&K /�--t/e�✓/JBG� E _4 J s STREET ADDRESS CITY,STATE,ZIP PHONE X 77 VAf.GCY �✓sF /'1l`P/Zqs c4 9S03S CSo—5" ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE of 9d SFD or Duplex [IMulti-FamilyPROJECT IN WILDLAND J PROJECT IN STRUCTURE: El Commercial URBAN INTERFACE AREA E] Yes DZ NO FLOOD ZONE ElYes R NO to SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELSIUNITS: r KILOWATTS(COMMERCIAL ONLY): 2 TOTAL VALUATIO�. J r DESCRIPTION OF WORK ` r Z /< Levo op PV so 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 ha a 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 relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED • oFvic 'usE oNi Y W ,OVER THE-GxN O,U�ITER EXPRESS gig U � TARGE; a MAJOR+ . PVApp 2011.doc revised 03/16/11 �a SMOKE f CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT<BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingCcDcupertino.om Permit No. _ Address — 10 Tj #of Alarms Smoke: Carbon Monoxide: PERMIT CANNOT S F LED AND COMPUTED {1NTIL THiS,GERvI i`, T ° 5 BEET' R I C7RD T TRE I3 � �G DI'SON . 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 R314 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 COALARM 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 s� Within each sleeping room X Carbon Monoxide alarms.are not required in dwellings which do not contain fuel-burning appli es and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall con Lply 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 batter 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 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 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. l have read and agree tg comply wi the terms and conditions of this statement O ner(or Owner Agent's)Name: r f � Utia 1w it o c� rami �s�i1 nature ........... ....:.. .............................. .. ............................ ............_ ate:`6./ 1.1.6 Contractor Name: Signature.........................._.......................................Lic.#...................................... ate: ................... Smoke and CO form.doc revised 03/18/14 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE P054R,11 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPE TINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (4Qf8 7w77i-3��33•buildingR-cupertino.org Owner Name I� l Permit No. -- Address 091 A �. • _ 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. Q/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 oi its plumbing,installation of water-conserving plumbing fixtures is not technically.feasible? Yes Civil Code Sections 1101.1 through 1101.8 do not apply. El The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of forma KJ/<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 forin. EU/<o 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 ol form. - s 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. Pleas check ONE of the following: y 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 plumbin 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 o 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- cons rvmg plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). 1,as the owner or owner's agent of this property,certify under penalty of perjury that non-compliant plumbing f aures 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 Manu acturer's installation requirements,and that the water-corse g plumbing fixtures comply with the requirements as indicated in the table on the following page. 3 Owner or Owner Agent's Signature: —Date: 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