B-2016-2756CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2756
1102 SCOTLAND DR CUPERTINO, CA 33014-SO51 (362 27 002)
SUNR.UN
INSTALLARON
SFAVICES INC
SAN LUIS OBISPO, CA
93401
`
OWNER'S NAME: JANA iiAN RAJAGOPALAN AND VELLORE 1tAJESWA
DATE ISS1U :911912
6
OWNER'S PHONE: 405-361-7231
P ONE ' : (4 3s 900
LI EN9FD C ONTRA TOR'C DFCT Amtnrr
BUILDING PERMT A:
License Glass Lic. #Zt5 Jtg
Contractor allNRUN INSTALL&T QN SERMIQE5 INC Date 0Bl30l =
XBLDG E T_ L
I hereby affirm that i am licensed under the provisions of Chapter (commencing
_ WCH X EN I COMMERCIAL
with Section 7000) of Division 3 of the Business aft Professions Code and that my
license is in full force and effect.
JOB DE RIP O
(N) 2 -PA L MOUNTED PV SYSTEM (5.3 W)
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self -insure for Worker's
J 4
Compensation, as provided for by Section 3700 of the Lab e, for the
\ \
performance ofthe work for which this permit is issued.
I have and will maintain Worker's Compensation Insuran e, as pr 'ded r by
Section 3700 of the Labor Code, for the performance of e work fo whi this
ll
. It bNOrArea:
Valuation: $11000.00
permit is issued.
ARPJJ .ANT CER11FI ATitlt+l
I certify that i have read this application and state that the abov
Information is correct. I agree to comply with all city and county Inance
APN Number;
Occupancy Type:
and state laws relating to building construction, and hereby autho e
362 27 002
representatives of this city to enter upon the above mentioned props
inspection purposes. Me) agree to save indemnify and keep harmle he
City of Cupertino against liabilities, judgments, costs, and expenses ich
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of thi permit.
TSN DAYS �F PERMIT ISSUANCE ORAdditionally,
the applicant understands and will comply with all n -point
source regulations pe a Cu 'no Municipal Code, Section AS.
180 DAYS FROM LAST" CALLED INSPECTION.
qIssued
Signature D a
by: Abby Ave de
DECLTION
Bate: 92114l2ti16
I hereby affirm that I am exempt from the Contr or's License Law for one of the
following two reasons:
RF' M
All roofs shall be inspected prior to any roofing material being installed. If a roof is
L 1, as owner of the property, or my oyces with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials flax
compensation, will do the work, the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Prof sions Code)
2. I, as owner of the property, am elusively contracting with licensed
Signature of Applicant:
contractors to construct the 'ect (Sce.7044, Business & Professions Code).
Date:
I hereby affirm under penalty of rjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR: BETTER
L I have and will maintai a Certificate of Consent to self -insure for Worker's
Compensation, as pr ided for by Section 3700 of the Labor Code, for the
performance of th ork for which this permit is issued.
2.. I have and will intain Worker's Compensation Insurance, as provided for by
k#A?1tFtD i MAiEFtI LB DIGI.OStiRe
I have read the hazardous materials requirements under, Chapter 6.95 of the
Section 3706 the Labor Code, for the performance of the work for which this
California health & Safely Code, Sections 25505, 25533, and 25534. 1 will
maintain compliance with the Cupertino Municipal Cede, Chapter 9.12 and the
permit is is ed.
Reath & Safety Code, Section 25532(x) should I store or handle hazardous
a. I certify t tin the performance of the k for which this permitis is issued I
material. Additionally, should I use equipment or devices which emit Hazardous
shalt employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Wo 's Compensation laws of California. If, atter snaking ibis certificate of
will maintain compliance with the Cupertino Mu elpal Code, Chapter 9.12 and
mtprion, I become subject to the Worker's Compensation provisions of the
the health & Safety Co ectia 2 5533, and 25534.
;
Labor Code, I must forthwith comply with such provisions or this permit shall
-
be deemed revoked.
owner or authorized agent:
APy'I ICANT CERTIFICATION
Date: ��
certify that 1 have read this application and state that the above information is
Icorrect,ccertifyt
I", OCONMC �t'Ft CY
t hereby aklrm that there Is a construction fending agency for the performance
agree to comply with all city and county ordinances and state taws
of work's for which this permit is issued (Sec. 3497, Civ C.}
relating to building construction, and hereby authorize representatives of this city
Lainder'a Name
to enter upon the above mentioned property for inspection purposes. (WO) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
k It TI(?loi
r i�iTE�T'� DF A
and will comply with all non -point source regulations per the Cupertino Municipal
A
I understand my pians shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date
ALTERNATIVE RPERMITAPPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
s.
• i• TORRE
• (408) 777-3333 CUPERTINO
PROJECT ADDRESS L : n
E3'WR'£RA7ANIE wu � r ,, E -"PHONE E-MAIL
a \j n a
STREET ADDRESSr
T
CITY, STATE ZIP FAX
CONTACT NAME ?� HONF-Akis`,. �. qa3U"> P,L
STREET ADDRESS „- T
C� STAT tP � �
FAX
0 OWNER 0 OWNER-B'UMBER ® OWNER AGENT 9COXTRACFOR M CO CTORAGBNT ® ARCMTECT ® ENGINEER. El DrVELOPER 0 TENANT
CiINTRACrORNAAiE-. $
LTCENSEi�1Ra6E LTCEhSfiTYPE £
BiJS.LTCR
COMPANYNAME I -M L
A.'X
STREET ADDRESS a � � � ,STATE, ZIP
PHONE
ARCMTBCTENGINEER NAME
L ENSE XMMER
BEDS. LIC 9
COh2PANY NAME E-MAIL
F
BAX
STREET ADDRESS CITY, STATE. ZIP
t
C
PHONE
USE OF ® 8FD Or Duplex 0 Multi -F ily
STRUCTURE: ® COMMerCial
PR03ECT IN WILDLATda 7\
URBAN INTERFACE A eS 0 No
PROJECT 1N
FLOOD ZONE ® Yes 0 ILIO
9-00—LAR PANELS
® ELECTRIC EHTCLE CH ROING STATION d SOLAR WATER HEATINO
® OTHER:
F'ORSOUAPANELS. NUMBEROF PANE TTS: KILOWATTS (COMMERCIAL ONLY): &r
TOTAL VALUATION:
DESCRIPTION OF WORK 4 ,.
a6sS"tP^,`,AL j� '`si.+'. �1�3d2y `p 3 ..
d I
By my, tore below, I certify to each of the following: I am the property owner or authorized went to act on the property ovnler's behalf, I have read this
appl ca$t and the infonnatton I have p ojded Is rrect. read the Description of Work and verify it Is accurate. I agree to comply with all applicable local
ordman s and state taus relating to bii Ing con actio thori e resentatives of Cupertino to enter ilea above -i ntifie property for inspection purposes.
S gnature of ApplicanttAgent: Date: tr -
S PPLEMENTA i?RMA IOI I RE'k
Q #
t
rF'
�r �aeA
8'I.
w�
PYApp 2011.doa revised 03116111
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2756
1102 SCOTLAND DR CUPERTINO, CA 95014-5051 (362 27 002)
SUNRUN
INSTALLATION
SERVICES INC
SAN LUIS OBISPO, CA
93401
OWNER'S NAME: JANAKIRAMAN RAJAGOPALAN AND VELLORE RAJESWA
DATE ISSUED: 09/19/2016
OWNER'S PHONE: 408-361-7231
PHONE NO: (415) 580-6900
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-46 Lic. #750184
Contractor SUNRUN INSTALLATION SERVICESINC Date 06/30/2018
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:
(N) 20-PANEL ROOF MOUNTED PV SYSTEM (5.3 KW)
I hereby affirm under penalty of perjury one of the following two declarations:
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
of the work for which this permit is issued.
performance
have and will maintain Worker's Compensation Insurance, as provided for by
ection 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Sq. Ft Floor Area:
Valuation: $11000.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
362 27 002
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.
Additionally, the applicant understands and will comply with all non-point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations pe `ihe Cu 'no Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
J '
/�
Signature Date "! '
Issued by: Abby Avende
OWNER BIfILDER DE 4,AIM
Date: 99112L2-0-1.6
,
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
t. 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:
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
z. 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 Co ectio 25 0 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:
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
ON I,FN4G AG ENCY
I hereby affirm that there is a construction i6nding 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,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
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
CUPERTINO
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
Ll 4
(408) 777-3228 " FAX (408) 777-3333 • building a.cupertino.org t ,- 0tt ^ �
PROJECT ADDRESS V V V I
I i
APN # ? j _ ^ ^
OWNER NAME y� �rO PH E-MAIL
E-MAIL
STREET ADDRESS ' I � V r ,DT A � D
0 9-I E
CITY, STATE ZIP
CA)PM-DN0 CA 61 50 1
FAX
CONTACT NAME Y/ e- j S
r"(� ✓
--�%
PHO E-MAILE- KE� 'S �rL (�-L � TTV
STREET ADDRESS ) 7 �
r
C STATES 7rjg � , _ w (�
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT
CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGMTEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME �` 'Q� (b j�
LICENSE NUMBER O' �j
LICENSE TYPE
BUS. LIC #
COMPANY NAMEkEiE
E-MAIL
FAXSTREET
ADDRESS �
ARCMTECT/ENGINEER NAME
CITY, STATE, ZIP
LICENSE NUMBER
PHONE
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
PROJECT IN WILDLAND
URBAN INTERFACE AREA ❑ Yes ❑ NO
PROJECT IN
FLOOD ZONE ❑ Yes ❑ No
OLAR PANELS
TO ELECTRIC VEHICLE CHARGING STATION
TO SOLAR WATER HEATING
❑ OTHER:
FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: O KILOWATTS (COMMERCIAL ONLY): - +
TOTAL VALUATION: O
DESCRIPTION OF WORKS
f ^ O�� ` 4 re-0OF-
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have p ovided is rrect. Uwofread the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b 1 ng con ctio thori el;ntatives of Cupertino to enter the above -i ntifie i�operty for inspection purposes.
Signature of Applicant/Agent: Date:
S PPLEMENTA
I.) yav�
\L `f ,
FORMATION REQUIRED
soi.Yrzl a;'
A
$
`Y a
q,a xF7
a'BMs
y �.
�3 #�
PVApp_2011.doc revised 03/16/11