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B-2016-2374 CITY OF CUPERTINO BUILDINCT PERMIT BUILDING ADDRESS: CONTRACT PERMIT NO:B-2016-2374 11470 CHARSAN LN CUPERTINO,CA 95014-4974(362 10 046) SKYWAY ELECTRIC SAN JOSE,CA 95113 OWNER'S NAME: HUTCHINSON CHESTER RAND LORRIANE K DATE ISSUED:07/25/2016 OWNER'S PHONE:707-337-9797 PHONE NO:(408)418-4607 LICENSED CONTRACTOR'S DECL RATION BUILDING ERMIT INFO: License Class ELECTRICAL Lic.#387957 Contractor SKYWAY ELECTRIC Date 03/31/2018 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X SIDENTTAL—,COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCR)PTION: NEW;24 RO F TOP PV PANEL;7.2kW I hereby affirm under penalty of perjury one of the following two declarations: 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 performance of the work for which this permit is issued. z. 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:$21600.00 APPLICANT CERTIFICATION 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 36210046 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. WIT Additionally,the applicant understands and will comply with all non-point HIN 180 DAYS OF PERMIT ISSUANCE OR source regu s per the Cupertino Municipal Code,Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION. Signature e Date 07/25/2016 Issued by:MELISSA Dates 07/25/2016 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 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(Sce.7044,Business&Professions Code) z. 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:07/2_ 5/2 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. 1 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. 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 permit is issued,I Health&Safety Code,Section 25532(x)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 e,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:07/25/2016 <t 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. 1 understand my plans shall be used as public records. Licensed Signature Date 07/25/2016 Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228 FAX(408)777-3333•buildingp_cupertino,org CUPERTINO (3- -Zo 1- 7-3 PROJECT ADDRESS. �/ /may L'an'e APN# (!� -1 r ®� ( OWNER NAME / Ob lam h PHONE a � Z��`/ E-MAIL UT STREET ADDRESS 1y�� �ry p "P J { d✓ �L/�VL L r�'(. CITY, STATE,ZIP C' r-h b , FAX CONTACT NAMEF !' & PHONE "' (jS! E-MAIL STREET ADDRESS 1 e s{b/1 erY ye A � CITY,STATE,zIP *fi -e ` s+�} !g-3 FX ❑OwNER El.owNER-BuiLDER !❑ 'OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT Il ENGINEER ❑. DEVELOPER ❑ TENANT CONTRACTORNAME, ,�L 0_, �!✓s'i/`T LICENSFNUMBER� •? � LICENSET r j BUS.LIC# p-�I COMPANY NAME w E-MAIL- �j FAX STREET ADDRESS � l i ,� ^� CITY;STA.E,ZIP�x ��� �'� PHONE ARCI-HTECT/ENGINEER NAME l LICENSE NUMBER 1 i BUS.LICA# COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHOS USE OF ❑ SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No. FLOOD ZONE ❑ Yes ❑ No ❑SOLAR PANELS ❑ -ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: N FOR SOLAR PANELS: NUMBER OF P NFLS/UNITS: KILOWATTS(COMMERCIAL ONLY): c,' TOTAL DESCRIPTION OF WORK (( l8 PV Lam By my signature below,I certify to each of the following: I am the property owner or authorized agent t on t' rly owner's behal e read this application and the information I ha rovided is correct. I have read the Description of Work nfy it is accurate. I agree to c ith all applicable local ordinances and state laws relating to ding construe' n. I authorize representatives of Cupertino to enter the above nh operty for inspection purposes. Signature of Applicant/Agent: Dater SUPPLEMENTAL INFORMATION REQUIRED OFFIGI}bSEONLY OYER THE-COIINTER "R x ❑ STANDARD LA$GR �.., a ,x Q MAJOR` PV4pp_2011.doc revised 03116111 . /YEAR" MONOXIDE MARMSFILE OMER CM"nCM OF COMPLIANCE { GQTJIMUNITY'D;EVELDPIVIENT!GEPART I; MENT B°UdLD1:NG DIVISION CAi������;� 10300 TORRE AVEN,U.E a CUPt3RTINOG,�A 95014 3255 (408)777-3228 'FAX t(4D8)777-3333 ; uillirrptcuperfino orp LN4r�-fq Ulis affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance wif112013 CRC Section 8314,2013 CBC Sections 420.6 and 907.2-.11.2 where no interior access for inspections are required. GP,N- �At WFU IVIA7 ION F fisting single family and multi-family dwellings shall be provided with Smoke Alarms and Carbo n Ivfonoide alarrrts Wine-in the valuation of additions, alteratioins,or repairs to existing dwelling units exceeds $10'00 00,CXC Section RaM and CBC Sections 907 211,.5 aiid 420.6 require that S- oke Alarms anw.Or Carbon Monoxide Alarmsbe installed in the following locations ARIEA S-WPfKE ALAR, CO ti . t. At�,A Ck tside of each separate sleeping:area in the imrnedliate vLc>nify of the b'LOT®orn s X Ori e ery,feVel©f a dwelling,unit irtcliidiri ,base mats eAcht*q&A Toon X � 1 Carbon Monoxide alar=F s as e not regpired in dwellings,which.do root contain fuel-burn>n ���=t' g a ppliances an that d®nose i-I ana attached garage Carbon ritonOxide alarms combined w itfi somal e alarms shallconply wial CIBC Sect%o�n3 42a 6 wid small be app�r©vedl by the: Ll Office of the State Fire Ivlaashal.. Power Sutppl`y ZR dwelling,unmts with no cam' .,'erellApower'sutpply„alarm.omay be solely battery Oyer at"edl { In,exigstzn�g dwelling units; alarmi&are pperm,fitted to be 80t10y battery operated where repairs or a}ltera+ti_m1=s=cloy not-res-911 iT the removal Of wall;az d ceiling fic nishes or there is no°access by m=eans;of affil c,b�asee{. iri�enf orr crawl space Refer to CRC Section R3114 a rtd CRC Secfioins 90tT.211.4 aind 420.6.2..An electrical pe it is require t for aTarirts w mich must be connected to t he ,dding wmii2g. As owner of tire,above-refereiitced prroperty,:x hereby certify erenced above has/ltave b.ee instal}lied Inn=accord ,itc,e wit11 the ,a+allLl aCturer`S instructions aund in coistp=liance with the Californmia B�urld lg and,CaEl fonua Residential.Codes,'1h,e alarms It ave been tested; .i 1d are op:er,atimm11,as of the date s greed below., r G haver rreadrand a:,ee to com I,with Vie:t'erm�and conditibins,oFfJrs,sftemenh Ir ' St t]aE(r, R`WA ul Lt �� ...... � i WATER-CONSERVING PLUMBING FIXTURES F L OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE CUPERTINO,CA 95014-3255 (408)777-3228•FAX{408)777-3333.•building(a�cuoertmo.org _ COwa�er Nara ria ifs (Permit Nod 1�-1-.----IIsem--your real property a registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. I EX, 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? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the forin and sign bottom of form. r No Go to Question 3. 3. Is water service permanently disconnected for your building? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Lj P 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. ' ] 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: F__71 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). 0' 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). 0 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 irnprovements). 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: ' Daf �� /", Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB40 7 2015.doc revised 08126115