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B-2016-2836 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-2836 7893 ROBINDELL WAY CUPERTINO,CA 95014-5076(362 19 024) SUNRUN INSTALLATION SERVICES INC SAN LUIS OBISPO,CA 93401 OWNER'S NAME: HUEY HUGO ENG AND E-PING SHEN TRUSTEE DATE ISSUED:09/3012016 OWNER'S PHONE:408-973-1461 PHONE NO:(415)580-6900 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-46 Lic.#750184 Contractor SUNRUN INSTALLATION SERVICES INC 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: I hereby affirm under penalty of perjury one of the following two declarations: (N)15 PANEL ROOF MOUNTED PV SYSTEM(3.9kW) 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. 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 forwhich this permit is issued. Sq.Ft Floor Area: Valuation:$8151.00 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 362 19 024 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 regulatio per t upertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 09/30/2016 Issued by:SEAN HATCH; Date:09/30/2016 I hereby affirm that ra.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(Sec.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:09130/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 1 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. 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. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(al 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 Cupertin cipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Cod,Se s 2 5 25533,and 255 Labor Code,I must forthwith comply with such provisions or this permit shall 1 be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:09/30/2016 1 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 I hereby affirm that there is a constru4tatflending 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 DECIARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 09/30/2016 ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 GUPERT(Nfl" (408)777-3228• FAX(408)777-3333•buiIdlnq(cDcuPeItinO.DCq �- Z-0 16, Z_S .3.6 PROJECT ADDRESS ] f, APN Ir' j OWNERNAME � PH -g 1z q/ G E-MAIL STREET ADDRESS q CrATE,ZIP CONTACT NAME S ET ADDRESg ��11 /yY,STAT Z /r o /(¢ g yt t _ �SL' ❑ OWNER ❑ O�VI�'ER•BUILDER ❑ ORTIERAGENT INTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME`" /I / LICENSE I,TUMB LIC ' ETY E BUS.LIC 9 COMPANY NAME,A E-MAIL _ FAX �3 ;5R tw4tzlk) �/ CI 73�G6 TT / 2n�L 01 C157 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#/ COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE of SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ No 1,D96LAR PANELS TO ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PAAELS. NUMBER OF PANELSMTITS: KILOWATTS(COMMERCIAL ONLY): ®�/ /% TOTAL VALUATION: '. DESCRIPTION OF WORK / L � �� / ( K 51 0 By my signature below,I certify jhave f the fol i g: the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information Ivide sco t. averead the Description ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatinvin ons cti #lo jZe mpresentatives of Cupertino to enter the above-iide�ntifii d property or inspect' n purposes. S i.gnature of Applicant/Agent: Date: -- SUPPLEME AL INFORMATION REQUIRED / �y�..��C �/�69 f2 C1 "! !Ge/�( �� SH1•r'CO�JJ�yxER 4�u+�`r�"�# J . gWN 3 C CSTAT�DARI; 1...•.. , PIS,4Pp 2011.doc revised 03116111