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15120166-DPCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10665 CULBERTSON DR CONTRACTOR: CLEAN SOLAR PERMIT NO: 15120166 OWNER'S NAME: LAM TERENCE T AND CHRISTINE F 1445 KOLL CIR STE 109 DATE ISSUED: 12/17/2015 OWNER'S PHONE: 4088872118 SAN JOSE, CA 95112 PHONE NO: (408) 217 -8876 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ INSTALL (N) ROOFTOP MOUNTED SOLAR PV - 17 PANELS G License Class�sO(,I /D ( (-L9V Lic. # q((7 p �(5.36KW) Contractor liL`�L .t1. ��aLd� Date 1 I -�` 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 full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: 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 Sq. Ft Floor Area: Valuation: $24748 e rormance of the work for which this permit is issued. ave 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 permit is issued. APN Number: 37536031.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 M LAST CALLED INSPEC IO indemnity and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 5MLVWV6S Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source - Cations per Cupertino Municipal Code, Section 9.18. I I RE- ROOFS: Sig t Date l oLft 7 r All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER - BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, 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 for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertkfo Municipal Code, Chapter 9.I2 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & SafetLag , Sections 2550 33, d 2 534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authoriz Date permit is issued. I certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address 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 and state laws relating to building construction, and hereby authorize 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVEHLOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO. CA 95014 -3255 j'Gl- ,'j�o�/; (408) 777 -3228 • FAX (408) 777 -3333 • buildino@.cuc)ertino.org I�IIJ` 'C.A.J PROTECT ADDRESS ` _ -�� APN : 36 1131. (p OWt,cRNAII PH99h�°�� E -MAIL r`L STIE ADDRESS CIT FAX CONTACT NA14E ��O E_N—/.AIL ` FAX ❑ O%'IN-R ❑ OWNER- BUILDER ❑ OWNERAGENT DONTRACrOR ❑lCOOA7N R.ACTORAGENT ❑ ARCHITECT ❑ ENGII.'EER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENS LT1B uagqn ME BUS. LIC COMPANY NAME �p I E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP _.� b PHON£y e__ ARCHITECTINGINEER NAME LICENSE NUMBER BUS. LLICC 1 COMPANY NAME E -M.AIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ?<5FD or Duplex ❑ blulti-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ YES ❑ NO AR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER DATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/LVITS: KILOWATTS (COA'LA4ERCIAL ONLIO: TOTAL VALUATI .�� DESCRIPTION OF WORK ° By my signature below, I certify to each of the following: I am the pmperj' owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided i orrect. I have read the Description of Work and verify it is accurate. I a_ree to comply with all applicable local ordinances and state laws r= o building co I autho representatives of Cupertino to enter the abovee- -ide tir, drproperty for inspection purposes. Snature Applicant/Al2--11 Date: of . SU LE- \t L 1NFORAgATION REQUIRED z Y 0 HRSHE- COiJ2�'F R, LEM pt ST,'D.'iRDE `LARGE ;� � - z � �.5❑ � a - FV,4p2_2011.doe revised 03116111 CITY OF CUPERTINO J'N9,0166. W-W FEE ESTIMATOR — BUILDING DIVISION i9ADDRESS: 10665 Culberston Dr DATE: 12/17/2015 REVIEWED BY: PAUL s APN: 375 36 031 BP#: *VALUATION: 1$24,748 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: hrs PENTAMATION SOLAR-RES PERMIT TYPE: A WORK install (N) rooftop mounted solar PV - 17 Panels (5.36K\N) SCOPE Permit Fee: NUTE: "I his estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Di.vfrirt. etc. )_ ra"tart the [)ant fnr aild"'I info FEE ITEMS (Fee Resolution 11-053 Lff 7/11131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Alternative Energy System $236.001 IPHOTOVRES Photovoltaic System Suppl. PC Fee: (j) Reg. 0 OT 10.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 SLippl. Insp. Fee:(• Reg. 0 0TF6_-61 lirs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes (F) No $0.00 Advanced Illanniqg_Eee: $0.00 Select a Non-Residential G Building or Structure 0 q Sfron,,z Motion Fee- IBSF1,5MICR $3.22 Select an Administrative Item Bld—,, Std; Commission Fee: IBCBSC $1.00 ' ..... . $4.22 I $236.00 TOTAL d $240.22 Revised: 10/01/2015 1 CUPERTINO Address SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building( a�cuperti no. org ]'f LOo f j� ' �, L Permit No. I ` V l l) liltil�Q/Y 0h HIV �1�/v�N�/� Y)D # of Alarms Smoke: � Carbon Monoxide: 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 CO ALARM Outside of each separate sleeping area in the,immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including 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) 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 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. 1 have read and agree to comply with the terms and conditions of this statement CI L Owner � `'L s Name: Owner Agent�� Signature ............ Y�!. Y.'.: 4�. '. �....`": �� ... ............................... ..........................Date: �.'6./��.... Contractor Name: Signature.......................................................... ......... Lic.# .................... .............. ....Date: ... ....... .......... Smoke and COform.doc revised 03118114 CUPERTINO WATER - CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 `- (408) 777 -3228 • FAX (408) 777 -3333 • building aAcupertino.org I Owner Name C Y' ('l 7T f h ('i �G/1'✓� Permit No. Address 10 D0 Jr C i'ti.I b-KD h W, PAI Xff l h 0 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. $f No Go to Question 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 plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. ❑ No Go to Question 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. M 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 110 1. 1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. D( 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.. Please check ONE of the following: j 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). • 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 of whether property undergoes alterations or improvements). 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 followine naee. I Owner or Owner Agent's Signature: _ l `�/u� -1 `fill— W. Date: _ �� '� I Upon completing and signing this Certiticate, please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08126115 B1IIiDIIVG PERMIT CANNOT BE FI1V'ALED AND COMPILE? ED:LTNTIL'THIS . c- CERTIFICATE HAS BEEN SIGNED.AND RETU\TED TO THE 1BUILDIIVG DIVISION f 1. If the existing plumbing fixture water usage /flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc revised 08126115 Non - Compliant Water- Conserving Plumbing Fixture Plumbing Fixtures (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single - Family Multi- Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons /flush (Toilets) Gallons /flush Dual flush toilets: 1.28 gallons /flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons /flush Gallons /flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand -held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and /or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage /flow rate is equal to or lower than the figure shown, it is not required to be upgraded. 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