B-2016-1156CITYF CUPERTINO B IIIc GPERAUT
BUIL DRI(GADIDRESS:
CONTRACTOR-
P) If 4€ TNO. B-2016-1156
19920 OLIVEWOOLD ST CUPERT1NO, CA 95014-600 (316 43 004)
(SUN FIRST! INC)
SAN RAFA.EL,, CA 94903
OWNER'S s NAfi : ESSEX THE POINTE LP
DATE ISSf.ISLD: 01112/2016
OlA°NER'S PHONE:
PI14Dtai 44:
i.iffiblroL?19 CtDrl r [kl.'.S L2F r a n zAT Oh'
%$UMDING PERAUT INFO:
License Class Lic. (t /
Contractor (StFEI FfRaT1 IIVG Date . ^ !!
BLDG w ELECT PLUINiR
I hereby affirm that I am licensed cinder the provisions of Chapter 9 (commencing
M ECH X RESIDENTUL _ C01VIMERCIAL
with Section 74D0) o€!Division 3 of the Business & Professions Cade and that my
License is in fun force and effect,
JOB DESCRI ON
Install (20) pool solar panels on the carport+ automatic solar pool heating
I hereby affirm wider penalty of perjury one of the followingg two declarations:
system including installation of 1/2 HP booster.
1. 1 have and will maintain a certificate of eonseut to self-insure for Workees
Compensation, as provided for by Section 3700 of the Labor Code, for the
perfminance €af foe work far which this permit is issued.
I have and w li maintain *Marker's Compensation Insurance, as provided for
by Section 3700 orf the Labor Coale, for the pa rrformance of the work for which
Sq. Ft FloorAmai Valuation: $20000.00
this permit is issued.
APPUCANT CERT
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
.A.PN Number: Occupancy T°ypez
ordinances and state laws relating to building construction, and hereby
316 43 004
authorize representatives of this city to enter upon the above mentioned
property for inspection purposes. (Vie) agree to save indemnify and keep
harmless the City of Cupertino against liabilities, judgments, costs, and
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City In consequence of the
granting of this permit. Additionally, the applicant understands and will
1Q ,
ISSUANCE OR
comply with all non-point source regulations per the Cupertino Municipal
180 DA'Y'S FROM LAST CAL LED INSPECTION.
Goole, Section 9.18.
J
flats - / t `
Issued bw
Date:
,
f€€
�Sy4gnatureyyy y� {',,q
i3MM R BATIi N
RF,-R0 FS:
I hereby affirm ?fiat I nm exempt from the Contractor's License Law for one of the
.All roofs shall be inspected prior to any roofing material being installed, if a roof is
following two reasons,
installed without first obtaining ar, inspection, I agree to remove all new materials for
a. 1, as owner of the propeey, or my employees with wages as their sale
inspection-
compensation, will do the work, and the steuctutm is not intended or offered
for sale (Sm.7044, Business & Professions Cade)
SignatureofApplieant: —
z. L as owner of the property, arae c-Aclusively contracting with licensed
!Date:
contractors to construct ft project (Sec.7044, Business & Professions Cade).
I hereby affirm under penalty of perjury one of the following three declarations;
ALL ROOF COVERINGS L H3 CLASS seA:aOR BETTER
L I have and will maintain a Certificate of Consent to setf-insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Cade, for the
HAZARDOUS MA ERLAL S 61€;LOSUH
perfbaranee ofthe work for which this permit is issued
I have read the hazardous materials renulrements under Chapter 6.93 of the
s, I have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections '5505, 25:33, and 25534. I Will
by Section 3`100 of the Labor, Code; for the performance of the work for which
maintain compliance with the Ctzpertir o Nli mi pal Code, Chapter 9.12 and the
this permit is issued
Health & Safety Cotte, Section 25532(z) should I store or handle hazardous
3. 1 certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as debated by the Bay Area .A it Quality Alanagement District I
shall notemploy any person in any manner so as to become subject to the
will maintain compliance %ith the Cupertino Municipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
the health & Safety Code, Sections 25505, 25533, and 25534.
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
Owner or authorized agent
be deemed revoked
I1�1
APPLICANTCURTIFICA11ON
I certify that I have read this application and state that the above information is
CONST1RLt ILON LERUDING AGE�lt'Txr
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.) �
relating to building construction. and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save Indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against Bald City in
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consequence of the granting of this permit, Additionally, ft applicant-
Aiat 13IT�t I S f I
I understand nay plans shall be used as public records.
understands and will comply with all non-point source regulations per the
Cupertino Municipal Code, Section 9.18.
Licensed
Professional_
Signature - Bate
b�
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRa"" f "e,
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COW'4N'q' NAME
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FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF L SFD or Duplex muiti� amily
PROJECT IN WILDLANI)
P:tN
STRUCTURE: 0 Commercial
LRB.ILN INTERFACE AR= -A 0 Yes No
� FLOO€? ZONE 0 Yes 1"O
13 SOLAR P..w LS
0 ELEC'i C VEMCLE CT II RGiNG STATION = SOLAR WATER ; M h'P_NO
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FORSOLAR-PA ECS: IT#M3E QFPAN-1-1VtSs'Q S:��KIL#OW_A�"prTS(CO?iKBRCLBLONLIT.
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Ey nay signature below, I certify to each oif the following; I errs the Property ea a ae, r�F authorized rued Qeni to act on the prole s v € cs per's l `Z have, end th S
application and the information I have provided is correct. I have read tete Description of lorl, and verify it is accurate_
i free to comply with all applicable local
ordimnees and slate laws relating to buildi ns €rasa, I authorize, rely, esentatives of Cupertino to entar the above-identi aed property finr inspection purposes.
Signature ofApplicant{Agent: _ ;.
SUPP'LEMENT'AL II`rl''ORMATION REQUIRED
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191TA Z I :t
10300 TORRE AVENUE -CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - building
. LID—cupe
Zt"41 I Permit No."T�"7 0140-11
Address, Mvef'4010Y 4. Qvjlc4t�QA (4% of Alarms Smoke: 23 Z_ Carbon Monmide: t I tc�
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Mon.oxide 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 Alarins. and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000,00, C -RC 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:
AREASMOKE
ALARM
I
ALAfRM
Outside of each separate sleeping area in the immediate vicinity of the
b?d oorn(s)
X
!CO
X
On every level of a dwelling unit including basements
X
X
Within each slue in room
X
Carbon Monoxide. alarms are not required in dwellings which do not contain fuel-buming0 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 CIRC Section 8314 and CBC Sections 907,2.1.1.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above-refexenced 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
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Smoke and Wfiormdoc revised 03118/14
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is yon Teal property a registered historical site?
I Y Civil Code Sections 1101.1 through 11091.8 do not apply Skip the rest of the fonn and sib bottom of form,
No Go to Question 2.
. goes your fell property have a licensed plumber certifying Wit, due to the; age or configurations of the property or its
plumbing, installation ofwater-conserving plumbing fixtures i's not technically feasible?
0 `des Civil Cade Sections 11031.1 through 1101.8 do not apply,
0 'De Licensed plumb 's certification has been provided to the Building Division.
Slip the rest of the form and sign bortorn of form.
No iso to Question 3.
3. is water service perinariently disconnected for your building?
rI Yes Civil Code Sections 11131.1 through 1101.8 do not appy. Slip the rest of the form and. sigh bottoms of form.
15 No Go tot Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
C` No IVAY real property is built and available for use or occupancy after January 1, 1994,
Civil Code Sections 1101.1 through 1.1031..8 do not apply, Ship the rest of the form and sign bottom of fortm
_
Yes My areal property is built and available for use or os upaney~ on or before January 1, 1994.
.mow
Civil Code Sections 11091.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Please check QM of the following:
My pro"- is a single-family raldentlarl real property. See Civil Code Section 1101.4.
On, and ,after January 1, 2014, building alterations or improvements shall require all non-compliam 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 water-conservingplumbing fixtures regardless of whether
Pr o �d rgoes alt�dons or i�rov�u .
�ylsro Sam
a raaraltaartll ri'arrtral real proper dee civil % tion 1101 .5.
Ors ark after January 1, X014, specified buil i rg alte tiorss r improvements shall rewire non- compliant
pl g f t s to e r placed with water eonservilsg plrss irsg fixtures.
fan or before Janes l; t31 all €an cis shat t lur bmg ix es ll be replaced with water-
consm ving plunnbing fixtures tbro ghoul the building (regardless of whether property undergoes alterations or
improvements'i'
0 My pulp V is a commercial real property, See Civil Code Section 11031.5.
On and after January 1, 2014, specified building alterations or improvements shall require~ non- compliant
Plumbing Ifixiures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all .non-compliant plumbing firs shall be replaces with 'water- conserving
plumbing fixtures thwug o t the building (regardless of whether property undergoes alterations or improvements).
1, as the owner or o-orner's agent of this propel$ certify
replaced prior to date specified alcove with water consery
through 1101.8, the curresst CaliforniaPI g Code an,
installation requirements, axxsd that the wa r 0nserinn p
table on the fb!!2EIngja e.
oWner or OwnerAgent's Signatur
and signing this ertcat, please return it to
salty of per ury that non-compliant plumbing fixtures will be
binfixtures in accordance with Civil Code. ect ons 1101. 1
nia Green Building Standards Code, and manufacturer's
fixtures comply with the requirements as indicated in the
I
in order to final your
'0407 2011doc revised OW6115