B-2016-2924CITY OF CUPERTINO BUILDING PERMIT
BUELDING ADDRESS:
CONTRACTOR.
PERMIT NO: B-20 -2924
10312 E ESTATES,1 A CUP EIZTINQ; CA 950,14-3375 (369 07 021)
SUNRUN
INSTALLATION
SERVICES INC
SAN LUIS OBISPO, CA
93401
O'WNER'S NAME: CIIOU C1HE1v-Si1ENG AND YEH SIiU-CIMN TRUSTEE
DA .ISSUED: 10/17/2016
OWNER'S PHQNE; 415.505-5329
P. ONE NO: (415) 580-6900
LICENSEli COMRACTOR'S D CIA AR TION
BUILDING PE INFO:
License Class C-46 Lic, #750184
Contractor SUNRUN INSTALLATION SERVICES INC Date 06/30/2018
X BLDG _ E CT _ PLUMB
I hereby affirm that I.am licensed under the provisions of Chapter 9 (commenting
_MECHX SEDFNT1Ai,_C0MMERC1AL
.with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB D CRiPTION;
19 ANEL ROOF M UNTED PV SYSTEM (5:0 KW)
I hereby .affirm under penalty of perjury one of the following two declarations:
i. 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 perout is issued.
I have and will maintain Worker's Compensation Insurance, -provided for b
�
Section 3700 of the Labor Code, for the performance of the work for whi
/ c
.(
Sq. Ft Floo ea:
Valuation: $10450.00
permit is issued
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN N her:
Occupancy Type:
information'is correct. I agree to. comply with all cityand county ordin cos
36907
and state laws relating to building construction, and hereby authoriz
representatives of this city to enter upon the above mentioned .pro erty for
inspection purposes. (We)agree to save indemnify and keep h mless the
City of Cupertino against liabilities, judgments, costs, and exp ses which
jE T EXPIRES Ila'O IS N®T STARTED
may accrue against said City in consequence of the grantin f this permit.
HIN Igo DAYS OF PERMIT ISSUANCE OR
Additionally; the applicant understands and will comply wit all non-point
source regulations per the perlino Municipal Code, Se on
0 DAYS FROM LAST CALLED INSPECTION,
117/2018issuedby:AbbyAygnde
Signature Date i
Date: 10/171016
I hereby affirm that I am exempt from the Ca actor's License Law r one of he
RE-ROOFS:
All roofs shall be inspected prior to any goofing material being -installed If a roof is
roofing
following two reasons:
i. I, as owner of the property or my a loyees with wages as their so.
installed without first obtaining an inspection, IRS= to remove all new materials for
compensation, will do the work, d the structure is not intended or offered for
inspection.
sale (Sec.7044, Business Ec Pr essians Code)
2, I, as owner of the property, exclusively contracting with licensed
Applicant:
Signature 7/2016
contractors to construct the roject (Sec.7044, Business & Professions Code).
Date: 10/17/
I hereby affirm under penalty of erjury one of the following three declarations:
AIS,ROOF COVERINGS TO BE CLASS "A" OR BETTER.
1. I have and willmaint a Certificate of Consent to self-insure for Worker's
Compensation, as vided for by Section 3700 of the Labor Code, for the
performance ofth work for which this permit is issuetL
FlAZARDOUS'MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
z. 1 have and will intact Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 2$50$, 25533, and 25534. I will'
Section 3704 .. the Labor Code, for She performance of#he work for which this
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is iss ed
Health &Safety Code, Section 25532(a) should I store or handle hazardous
3. 1 certify t in the performance .of the work for which, permit is: issued, I
material. Additionally, should! use equipment or devices which emit hazardous
shall no employ any person in any manner so as to become subject to the
air contaminants as defined by the BayAreaAir Quality Management District
Work 's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino M ; cipal Code, Chapter 9.12 and
axe ption, i become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sectio 5 5, 25533, and 25534..
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked. `
.owner or authorized agent:
Date- 10117/201 6"
APP CANT CERTrFrCATION
CONSTRU
I certify that I have read this application and state that the above information is.
.
1 hereby affirm That there is consdo 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 iss {Sec. 3097, Civ C:)
relating to building construction,. and hereby authorize representatives of this city
Lender's Name
toenter 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 said City in
consequence of the granting of. this permit. Additionally, the applicant understands
AIR TFCT'S DECLARATION
and will comply with all non-point source regulations per the Cupertino MunicipalI
understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature pate 10/17/2016
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION.
70300 TOR.RE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 - buildinaacuoer ino.org.
NO
PROJECT ADDRESS i � �j � �!�.{�� ���;i� �(/�
APN *
OWNERI AME �1 t� } .t% T�[ �{j�"� (!� l��- 7q , J
PHONE �+q �� f1 . LT E MAIL
STREETADDRESS
&1)c� � � t t� D I' -! FAX
CONTACT NAMEq' { PHONE Q j
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EMAIL iytp �� 1 •�yir`i d �` �Ig �
STREET ADDRESS y . — CFAX
ST TE„t ZI y ry f }
Vk .F
I3 OWNER ❑ OWNER -BUILDER El OWNERAGENT EVONTRACTOR -❑ CONTRACT AGENT in ARC= T 13 ENG , ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME jt r
1
LICENSE NUMBER � � �j�
LICENS T E
US. LIC 9 l ' 2,
COMPANY NAME
r
L
FAX
STREETADDRESSe U v
CI TATE, aP
PHONE
ARCHITECTLENGINEER NAMELI
' NUMBER
US. LIC 0
COMPANY NAME
E-MAIL
F
STREETADDRESS _ _. .. .. ..
CITY, STAT ZIP +. rw
'PRONE.
USE OF 0 SFD or DurdeX : ❑ Multi -Fain.
PROJECT IN WILDLAIv
PROJECTIN
STRUCTURE: D Commercial
URBAN INTERFACE A . Yes D NO
FLOOD ZONE D Yes ❑' No
❑ SOLAR PANELS
El EI.EGIRIC VEHI £CHARGING STATION
❑ 30LAR1�JATERHEATINO
❑ OTHER
FORSOL.4RPANELS: NUMBER OFPANELS S: l KULOWATrS(COMI,4FRCIALONLY): a
TOTALVALUATION: j2
DESCRIPTION OF WORK
MAIN%
T
PIN
By my signature below, certify to each of the following: I am the property owner or authorized agent to act on the property ounier's behalf.^l hav read.this
application and the info mation I have pp"rovided is co ,'ect I have read the Description of Work and verify it is accurate. I agree to comply With all applicable local
avel turd dentifi d for inspection
ordinances and state la s retating %cons ion. I authorize representatives of Cupertino to enter the above- property purposes.
Signature of Applicant/Agent: Date-
SUPPLENMNTALYNFORMATION REQUIRED
MOM
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A
a 011-0
ag
PTIApp_,2011.docrevised 03116111
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2924
10312 E ESTATES DR CUPERTINO, CA 95014-3375 (369 07 021)
SUNRUN
INSTALLATION
SERVICES INC
SAN LUIS OBISPO, CA
93401
OWNER'S NAME: CHOU CHIEN-SHENG AND YEH SHU-CHEN TRUSTEE
DATE ISSUED: 19/17/2016
OWNER'S PHONE: 415-505-5329
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
MECH X RESIDENTIAL
COMMERCIAL
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.
JOB DESCRIPTION:
(N) 19 -PANEL ROOF MOUNTED PV SYSTEM (5.0 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
performance of the work for which this permit is issued.
z 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
Sq. Ft Floor Area:
Valuation: $10450.00
permit is issued.
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
369 07 021
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 Apertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION,
Signature Date 10/17/2016
Issued by: Abby Aynde
Date: 10/17/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed If a roof is
following two reasons:
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)
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: 10/17/2016
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
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 ofthe work for which this
California Health &Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued,
Health & Safety Code, Section 25532(a) should I store or handle hazardous
3. I 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
shall not 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
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino M. cipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sectio S 5, 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: X17/2016'
I certify that I have read this application and state that the above information is
I hereby affirm that there is a constr do 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 iss (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 said City in
consequence of the granting of this permit. Additionally, the applicant understands
ARCHITECT'S DECLARATION
and will comply with all non -point source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18.
.Licensed
Signature Date 10/17/2016
CUPERTINO
ALTERNATIVE ENERGY PERMIT APPLICATION Am
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) /77-3333 building (ofcugertino.org '
gW
PROJECT ADDRESS � ! jes-i-A>p� D?2
APN #
OWNERNAME�Ii1."j�( �C i ( 1- rq� J PHONE (f11G o'5 EMAIL
/ 0. �
STREET ADDRESS `S' (F T �l✓ CIT IFAX
q f �s' ! .� '1.J [ k ci o l
CONTACT NAME PHONE t 3 Li
E-1iAIL9•
STREET ADDRESS a Wo
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FAX
❑ OWNER ❑ OWNER -BUILDER 1:1 OWNER AGENT NTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER El TENANT
CONTRACTOR NAME LIC£NSENUJvIBER� g q y
f ✓kJ i�
LICENSE TYPE
BUS. LIC R q
2 39 6
q
COMPANY NAME itl
1 -FAIL
FAX
1 /19l
STREET ADDRESS V y _
AT` TE, ZIP
PHONE
ARCHITECTMNIGINEER NAME
LICENSE NUMBER
BUS. LIC m
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex .: ❑ Multi -Family
PROJECT IN WILDLAIN'D
PROJECT IN
STRUCTURE: ❑ Commercial
URBAN INTERFACE AREA E) Yes ❑ No
FLOOD ZONE ❑ Yes ❑ NO
❑ SOLAR PANELS
❑ ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER HEATING
❑ OTHER:
FOR SOLAR PAXELS., NUMBER OF PANELS/UIN'1TS: ' ( KILOWATTS (COMMERCIAL ONLY): ("
TOTAL VALUATION: p�
DESCRIPTION OF WORK s 0 UVW-) t t ^ g _i j S
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 havA read this
application and the information I have pprovided is co ect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and laws relating to 1 ildin Icons re iion. I authorize representatives of Cupertino to enter the abopve- dentifi d for inspection
state property purposes.
Signature of AppIicant/Agent: lit r Date:
SUPPLEMENTALVFORMATION REQUIRED `}
R,CEus onzY,
M
OF awdms
kE7CPRE33 xa .
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STAJN"�D,ARD-4
Pl,'App 2011. docrevised 03/16/11