B-2016-2585 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2585
10221 BONNY DR CUPERTINO,CA 95014-2903(359 12 033) SLINGSHOT POWER
INC
LOS ALTOS,CA 94022
OWNER'S NAME: PASSANT3APRAKASHGEORGE AND SMITHAPRAKASH DATE ISSUED:08/25/2016
OWNER'S PHONE:408-504-0985 �IRONENO:(650)308-9055
LICENSED CONT A TOR' D RATION BUILDING PERMIT INFO.
License Class SOLAR Lic.#984488
Contractor SLINGSHOT POWER INC Date 06/30/2017 _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:
I hereby affirm under penalty of perjury one of the following two declarations: (N)17-PANEL ROOF MOUNTED PV SYSTEM(5.70 KW)
n. 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.
/ 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:$24485.00
APPLICANT CERTIFY ATIOiV
Icertify that 1 have read this application:and state that the above
information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 359 12033
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point.
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
�
Signature Date8/25/2016$L25L214� Issued by:Abbvyende
Date:08/25/2016
OWNER-BUILDER DECLARATION
I hereby affirm that I 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
n. 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. 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:8/25/2016
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 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 r or authorized agent: --
APPLICANT CERTIFICATION Dater 8/25/2016
1 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.
Signature Date 8/25/2016 Licensed
Professional
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO, CA 95014-3235 AL
CUPERTI NO (408)777-3228 FAX(408)777-3333 buildingagugertino.ora
PROJECT ADDRESS \ (�\ t'I ( APN R
STREET ADDRESS
FCI;TY, STATE,ZIP ( I] 1 ^e Y V FAX
CONTACT NAME, �
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STPDET aDDP SS /IA�,, /J I CITY,STATE,ZIP
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OWNER ❑ O\VNcR-BU.i_DcR ❑ OWNS AGENT ❑ CONMA.CTOR ❑CON71K4CTORAGEN1 ❑ ARG1TcC ❑-?�
t GE,�R ❑ Derr poER ❑ '^
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ARCM.-CTrnNGLr EER NAME � LICENSE NUMBER
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COMPANY NAME ( E-MAIL
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STREET ADDRESS CITY,STATE,ZIP PH01\'-=
t1sE OFD Or Duplex ❑ 1L4lllfi-F=miIy PROJECT i wILDL.aND PRorCi IN
STRUCTURE: ❑ Commercial I URBAN INTER FA C B A RE A ❑ Yes ❑ NO FL OOD ZON`^'= ❑ Yes
p No
SOLAR PANELS ` ❑ ELECTP.IC VESICLE C 4P(31NG STATION ❑ SOL.9R WATER E-.4TING i ❑ OTHER:
1 CR SOLAR PAArc'LS: NtitJ_B=R OF PAN=- SA'NITS: KILOWATTS(COM?«RCIs.L ONLI'): 15,-Z 0 TOTAL VAr DATION:
DESCRIPTION OF WORK
y T�s, n�'u e o io I c } o e o the oi_Io mQ' I an the property o\i n,.,or autho ized ag nt to act on th prope Ly ov'Ter s behzlr. I have read this
application and the infer ion I have.provided is Correct. I have;esd the Description ofWork and`L.rit,it is a-_cur te. I agee to compty with all applicable local
ordinances and Stare l LLS la ng to building constTIJction. I authorize representatives of Cupenino to enter the above-identified/propenyy for inspection purposes.
Si_naureof pplican/4� nt. } — --=----- ^ ,/� --- Dater / < <C
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PT!�pp_2011.doc revJ_ed 03/16/i 1
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SMOKE / CARBON-MONOXIDE ALARMS { v
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
Gt1PERTtNO
10300 TORRE AVENUE,CUPERTI
NO,GA 95014-3255
(408)777-3228•FAX(408)777-3333 buildinftuoertino.ofp
Z Permit No. ' ,
Address 2 LXX 1 {1 ir{ PSI d ( #of Al s S o e: Carbon.-Monoxide:
PERMIT OT BE FINALEDAND COMPLETED UNTIL THIS CERTIFICATE.
HASPBEENr �r�n AICD RFTLiRVED,TO THE BUILDING DIVISION
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for
complan with 2013 CRC Section R314,-2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GFNF,RAII 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 hi the following.locations:
AREA SMOKE ALARM CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the X X
bedr rn(s)
Onev level of a dwelling unit indudin basements X X
Witlihi each sleeping room
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 existin 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 mean's of attic,basement or crawl
space.Re r to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for
alarms wl ich 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.
t have read and agree to com f terms an' conditions of this statement
owner(or Owner Agenrs)Name:
......ffOlgS0.rit S' nature.... Date:
Contra lor Name:
qty L4C7 f
f Si nata Lic.#..... . ........ Date: f
Smoke and CO form.doc revived iced 03118114
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE L ,°
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CU,FE TING '10300 TORRRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228-FAX(408)777-3333-building cuaertinz om
Owner Name .21ZA V Permit No.
Address
.(4
I. Is your real property a registered historical site?
0 Yes C Nvil Code Sections 1101.1 through 1101.8 do not apply. Slap the rest of the form and sign bottom of form.
l9 No Go to Question 2.
2. Does your property have a licensed plumber certifying that,due to the age or configuration of the property- � � p perty or its
plumbing,' lation ofwater-conserving plumbing fixtures is not technically feasible?
11,Yes Civil Code Sections 1101.1 through 1101.8 do not apply:
The licensed plumber's certification has been provided to the Building Division.
kip the rest`of the form and sign bottom of form.
No Go to Question 3.
3. Is water serice permanently disconnected for your building?
Yes CiNil Code Sections 1101.1 through 1101.8 do not apply. Slip the rest of the form and sign bottom of form.
No Go to Question 4,
a
4. Is your real propertybuilt and available for use or occupancy on or before January 1, 1994?
0 No ly 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 ly real property is built and available for use or occupancy on or before January 1, 1994.
ivil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
ottom of form.,
5. Please check ONE of the following:
My property is a single-family residential real property, See Civil Code Section 1101.4.
Ori and i fter January 1,2014,building alterations or improvements shall require all non-compliant plumbing fixtures
to be rep iced 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 dergoes alterations or improvements).
0 My propi rty is a multifamily residential real property, See Civil Code Section 1101.5.
On and er'January 1,2014,specified building alterations or improvements shall require non compliant
plumbinj fixtures to be replaced with water-conserving plumbing fixtures.
On orbe ore January 1,2019,all non-compliant plumbing fixtures shall be replaced with water-
conservii g plumbing fixtures throughout the building(regardless of whether property undergoes alterations or
improve nts).
D Myprop rtyis a commercial real property. See Civil Code Section 1101.5.
On and a r January 1,2014,specified building alterations or improvements shall require non-compliant
plumbinj fixtures to be replaced with water-conserving plumbing fixtures.
On orb fore January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water conserving
phnnbin 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 11011.1
through 1101.8,the current California Plumbing Code and Califo 'a Green Building Standards Code,and manufacturer's
installation requirements,and that the water-cons g p mb` fixttures_ omply with the'requirements as indicated in the
table on the following p!gew
Owner or Owner Agent's Signature: Date: :?qL 2 It,
Upon co pleting and signing this Ccrtikat--jlfease return it to the Building Division in order to final your building permit.
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