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B-2016-2331 i CITY OF CUPERTINO BUILDING PERMIT j BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2331 10190 HILLCREST RD CUPERTINO,CA 95014-1023(326 16 064) SOLARCITY CORPORATION SAN MATEO,CA 94402 OWNER'S NAME: MERRICK ROBERT G TRUSTEE&ET AL DATE ISSUED:07/18/2016 OWNER'S PHONE:408-218-1448 PHONE NO:(650)963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class 1 0 Lic.#B33104 Contractor 9QLARCITY CORPORATION Date 12/31/2016 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: ADD TO(E)SYSTEM;(N)15 PANEL ROOF MOUNTED PV SYSTEM I hereby affirm under penalty of perjury one of the following two declarations: (3.9kW)BACK SIDE OF ROOF 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 r -!performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by f Section 3700 of the Labor Code,for the performance of the work for which this peris issued. Sq.Ft Floor Area: Valuations$8500.00 APPLICANT CERTIFI ATION 1 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 16 064 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 conssr''bence of the granting of this permit. Additionally,the applicant understands andA, ill comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cuperti ti Murc pal Cade,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature / Date 07/18/2016 Issued by:MELISSA NAMES ✓' Date:07/18/2016 -QMMR-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOF following two reasons All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 1,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&Professions Code). Date:07/18/2016 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 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 which emit hazardous air contaminants as defined by the Bay Area Air Qu#y Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Mun'eipai,� e,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 2 ,75,2 53 ,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:47/18/2016 1 certify that I have read this application and state that the above information is CONSTRZfCTION LENDING AEN 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 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. 1 understand my plans shall be used as public records. Signature Date 07/18/2016 Licensed Professional i ALTERNATIVE ENERGY PERMIT APPLICATION 0,Mrb UN1 Y i)1 ELOPI'01sENT DEPARMAI;, xt =c R R E ^VENUE->CUPERTHNA10, ! 950,14-3255 uPt7'3 { 1 `777-37:8•FXX X40 ,. . 3 raw bui�d�ncl Ca;g en . :, ZO 16 - Z_33 J PROJECT ADDRESS l l/ 0 U `t\ e—Ye—SA APN A 0 OtVNER NAME 610 e°A �'r°r\Ck..K- PHONE _, �q 1 L C( E-MAIL STREET ADDRESS j f E`p` " ��`"` '��°\CI�l� 4�.�• CITY,STATE ZIP FAX ��[ A (}��[5 CJ i CONTACT NAME fi A�r®an Javanrnard PHONE 650.477.6430 E-MAILmjavanmard@solarcity.com' STREET ADDRESS p ` 391 Foster Cit Blvd CITY,STATE,ZIP Y Foster Clay, CA 94404 FAX ❑OWNER ❑ OWNER-BUILDER ❑OWNER AGENT ❑ CONTRACTOR NCONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑.TENANT CONTRACTOR NAME (* SolarCity Corporation LICENSENUMBER888104 LICENSE TYPE C10 BUS.LICn2384 4 COMPANY NAME C+®'C�rlslt Corporation E-MAIL a� . dVo 1 F GS3 i7 Y ,p m�avanmard@solarcity.com STREET ADDRESS 391 Foster Cit Blvd CITY,STATE,ZIP Y Foster City, CA 94404 PHONE650.477.6430 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC k COMPANYNAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP � PHONE USE OF 9 SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRL�URE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑` Yes ❑ No Is SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑. SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELSAJNITS: Is KILOWATTS(COMMERCIAL ONLY). �;� TOTAL VALUATION: DESCRIPTION OF WO d -6 E s S-}e,� Installation t.5 ) rooftop flush mounted solarpanel ) kali By my signature below,I certify to each of the following: la rr�'Ke prpgty owner or authorized agent actix the property Oti e alf. i have read this application and the information I have provided is correct. I Re re d }fe 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 112;eze errepresentatives Of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/tlgent: Date: 0 8 SUPPLEM ICTAL INFORMATION 103QUTRED OFFICE USE ONLY. OVER-THE-COUNTER I" EXPRESS. L4 `' C1 STANDARD �s l LARGE MAJOR PVApp_2011.docrevised 03/16/11 DocuSign Envelope ID:9789F978-7EBE-4CE6-AO8E-06D6F8DD4E6E rc FIL iii ro SMOKE! CARBON MONOXIDE ALARMS -�� OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTIN O 10300TORRE AVENUE•CUPERTI NO,CA 95414-3255 (408)777-3228-FAX(408)777-3333•build ing(akuAertina.9rq Permit No., Address 10190 Hillcrest Road Cupertino, CA 95014 {ofA{arruc }oke: EarbonMonoxide: ._. PERMt'i C 11Vl�It}T BE FINALEI}AND CUMPL,*.1 IJ1�1TI1 THIS CERTIFICA')'E ...... ..... ...... .: .,..:. 'tel.... .. 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 507.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-fatnily.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 831.4 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 vidnity-of the X X bedroom(s) On every level of a dwelling unit includiU 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:tri 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 R314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which trust 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 a ree to comw' t terms and conditions of this statement Owner(or Owner Agent's) tame: Robert G Merrick Iw ,'�LYYIUC h E 6/22/zo (Si nature........... .... ........... ........ . ................................ .............. Contractor Name: Signature. .Lic.# .Date: Smoke and COform.doc revised 03118/14 DocuSign Envelope ID:9789F978-7EBE-4CE6-A08E-06D6F8DD4E6E J7J7 WATER-CONSERVING PLUMBING FIXTURESFILE0•� 19 jt7VIfNER CERTIFICATE OF COMPLIANCE _u_7 COMMUNiTY DEVEI:tJ1't'1lENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE•CUPER 11NO,CA 95614-3255 C UP E RTi Ik[O �� (408)777-3228-FAX(408)777-3333•builctlnOt_cupertlno.orQ Owner Name Robert G Merrick 1'errnitNo2 M2 317/ Address 10190 Hillcrest Rd, Cupertino, CA 95014, US (SANTA CLARA County) PERMIT CANNOT BFV.FiNAV9D.ANI]CDNJPLE!" Ui'+Ir TMS*CIERTIIi ICATE HATHS;:BUILDIN OM 51QN= Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification farm. 1. Is your real property a registered historical site? I Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner'Signature: Date: [�_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 phimbee s certification has been provided to the Building Division. Sign below and skip the rest of the farm. C?wner'Signature: Date: 1 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. Sign below and skip the rest of the form. Owner'Signature: Date: (No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 19942 17 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. Sien below and skip the rest of the form. Owner'Signature: Date: 0,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. Refer to the attached. I-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 shalt 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). Cl My property is a multifamily residential real property. See Civil Code Section 1101.5.. On and after Jamary 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 ofwhetherproperty undergoes alterations or improvements). ❑ Myproperty is a coinmercial real property. See Civil.Code Section 1101.5. On and.after January 1,2014,specified building alterations or improvements shall require non eotnpliaut plumbing fixtures to be replaced with water conserving plumbing fixtures. SB4072019.doe revised 03118114