B-2016-3284CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-3284
6283 SHADYGROVE CT CUPERTINO, CA 95014-4643 (375 41 027)
WILLOW GLEN
ELECTRIC INC
SAN JOSE, CA 95155
OWNER'S NAME: NADKARNIANSHUMAN SAND RENUKAA
DATE ISSUED: 12/16/2016
OWNER'S PHONE: 408-806-5633
PHONE NO: (408) 289-9725
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C110 Lie. #591918
Contractor WILLOW GLEN ELECTRIC INC Date 04/30/2018
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:
INSTALL EV CHARGER AT CARPORT W/60 AMP BREAKER (SEE
I hereby affirm under penalty of perjury one of the following two declarations:
LOAD CALCS ON PLANS)
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.
W,U 2." ' 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: $2190.00
permit is issued.
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
375 41 027
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 regulati n perjhe Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 12/16/2016
Issued by. MELI
OWNER DECLARATION
Date: 12/16/
-BUILDER
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
m. L 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: 12/16/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
m. 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
a. 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
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 Municipal Code, Chapter 9.12 and -
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 2 505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:y' fJ GI
APPLICANT CERTIFICATION
Date: 12/16/2016
1 certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
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
to enter upon the above mentioned property for inspection purposes. (We) agree
Lenders 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
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 12/16/2016
Professional
.;
a
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (403) 777-3333 - bui1dIQqQcunertino,gM
UA
PROJECT ADDRESS
#
OWNER NAME AAj.5gwlt,,4�v �`®1441
PHONE �f - ,r m � p
3
E-MAIL
STREET ADDRESS gn. 'I .,�
CIT�Yg, iSTATE, Z�I�P,A' ,g� }y�S �^ L �.�-.� jet,
FAX
CONTACT NAME Mark Londre
PHONE (408)289-9725
E-MAIL
office @willow lenelectric.com
STREETADDRESsR O. Box 8430
CITY, STATE, ZIP San Jose, CA 95155
FA" (408)289-9725
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHIJECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
__7CONTRACTORNAMEMark Londre
LICENSE NUMBER 591918
LICENSETYPE ^-10
Bus. LIC# 15897
COMPANY NAME Willow Glen Electric, Inc.
E-MAIL office@willowglenelectric.com
FAX (408)289-9725
STREETADDRESS R U. Box 8430
CITY, STATE, ZIP San Jose, CA 95155
PHONE (408)289-9725
ARCHITECT/ENGINEER NAME NSA
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF Vf SFD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
PROJECT IN WILDLAND
URBAN INTERFACE AREA ❑ Yes ❑ NO
PROJECT IN
FLOOD ZONE ❑ Yes ❑ NO
❑ SOLAR PANELS
1sCl ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER HEATING
❑ OTHER:
FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY):
TOTAL VALUATION:^ / d0
DESCRIPTION OF WORK ` r }�
Electric Vehicle Charging Circuit: FWEA -S- 11 /A)='' E.. CI t/
&M -t -C- OF CAISPOAT 10
EI
By my signature below, I certify to each of the following: I am the property owner or autholized agent to act a pro . rty owne ' ehalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agre comply with all applicable local
ordinances and state laws relating to buildi on ct. 1. autho ' e representatives of Cupertino to enter the above -identified pro11 perty for inspection purposes.
Signature of Applicant/Agent: a'1 % / Date: ' I" l
SUPPLEMENTAL INFORMATION REQUIRED
-
OI:FICE USE ONLY
W OVER-THE-COUNTER
.
❑ EXPRESS
W
CO STANDARD
❑ LARGE'
-
❑ MA7oR f
PVApp_2011.doc revised 03116111
Install one 240 Volt 60 Amp dedicated circuit with an included Tesla
Wall Connector on the right wall of the outdoor carport for EV
charging. This circuit will provide up to 48 continuous amps for
charging. Surface -mounted 3/4" EMT w/ #6 THWN conductors & #10
THWN ground will be used to route the circuit from above the
outdoor main electrical panel to the garage, and in the garage to the
area behind the new Tesla Wall Connector location.
�Anshuman Nadkarni
6283 Shadygrove Court
Cupertino CA 95014
(408) 806-5633
200A Main Panel (E)
w/ 60A breaker (N)
COMMUNITY DE'
BUILDING E
House
0 AP
3/4" EMT This set of plans and specificE
#6 THWN COyJ�dq'1'E"tbT)§s1ruction. It is ur
alterations on same, ort devi
#10 THWN ground (N) from th,- Bui
The stamping of this plari and
held to permit or to be in a
provision of any Zflty C
Carport BY G, allllagO Name
DA E 12/16/16
PERMIT NO B-2016-3284
C
Tesla Wall Connector (N)
CUPE RTINO Driveway
Building E epartment
REVIEWED FOR CODE COMPLIANCE
Reviewed By: Melissa Names
Date: 12/16/16
Anshuman Nadkarni Page 1
)PMENT EPARTN
ION - C ERTINO
MUST be kept at the job
it to make any changes or
erefrom, without approval
Official.
cifications SHALL NOT be
ral of the violation of any
ance or State Law.
Residential Electrical Load Calculation
Site Location:
Prepared by
Anshuman Nadkarni
Willow Glen Electric, Inc. 1 L L C W
LEN
6283 Shadygrove Court
PO Box 8430 L E C T R I C
Cupertino CA 95014
San Jose, CA 95155 MIL
(408) 806-5633
(408) 289-9725 - office
General Lighting and Receptacle Loads [220.12]
3 watts per ft2 x 2,200 =
6,600
Small -Appliance Branch Circuits [220.52(A), 210.1(C)(1)]
1,500 watts
x 2 =
3,000
Laundry Branch Circuit(s) [220.52(6), [210.11(C)(2)]
1,500 watts
x 1 =
1,500
11,100
Fastened -In -Place
Appliances [220.53] Kitchen
Bath(s)
Outisde/Miscellaneous
Refrigerator(s) = 780
Instant Hot H20(s) =
Exhaust Fan(s)
=
Hot Tub =
Dishwasher(s) = 960
Hood Exhaust(s) =
Jacuzzi Tub(s)
= 1,920
Pool Equipment =
Garbage Disposal(s) = 600
Gas Range(s) =
Radiant Heating
=
Central Vacuum =
Microwave(s) = 1,200
Gas Oven(s) =
Steam shower
=
Sewage Ejector =
Trash Compactor =
Wine Fridge(s) =
Sauna
=
30A Circuit =
Steamer =
_
=
Garden Shed =
Total Fastened -in-place Appliance Load
5,460
Clothes Dryer(s) [220.54]
80% x
240
x
Derating
Volts
Amps
960
OR
Name Plate Rating
of Clothes Dryer
= 960
Ranges, Ovens, Cooktops, and Other Household
Cooking Appliances [220.55]
80% x
240
x 30 =
5,760
Derating
Volts
Amps
AND/OR
Name Plate Rating of Cooking Appliances
=
Heating or Air -Conditioning System (Compare the
heat and A/C, and omit the smaller.) [220.60]
Air Handler/Furnace
115
x 6.0 =
Volts
Amps
Air Conditioners
690
55% x
240
x =
Derating
Volts
AND/OR
Name Plate Rating of Air Handler & AC Units
=
Total Volt -Ampere Demand Load [220.83]
Greater of..,
Air-conditioning Equipment
690
x 100% =
690
Electric Space Heating
-
x 100% _
First 8kVA of all other loads
8,000
x 100% =
8,000
Remainder of all other loads
15,280
x 40% =
6,112
Total
14,802
Current Minimum Amperes
14,802:
240 = 61.7
Current Minimum
200 Amps
(voltage) (minimum amperes)
17 Size Service or
Feeder [240.6(A)]
currently
Electric Vehicle [625.14]
125% x
240
x 40 =
12,000
Continuous Load
Volts
Amps
Minimum Amperes with Added Load
Minimum Size
Divide the total 26,802:
240 = 111.7
Service or Feeder
200 Amps
volt-amperes by
(voltage) (minimum amperes)
20
w/ Added Load
with added load
the voltage.
[240.6(A)]
NOTES
All References are to 2014 National Electrical Code.
CUPERTINO
Building Department
REVIEWED FOR CODE COMPLIANCE
Reviewed By: Melissa Names
Date: 12/16/16
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Ljvcu,,j(,gn rnvejope IV r1 IG7248-F629-4A17-9015-F65F6961 D3135
=01 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE, CUPERTINO, CA 95014-3255 -
8) 717-3228 - FAX (408) 777-3383 - building(ftuoartino.orgo
Ra—mit NO. B2016-3284
Address 6283 Shadygrove Court #of`A1arms_Smo,k-e:6 — Carbon Monoxide: 2
PERMIT CANNOT BE FINALE D_ AND COMPLETED UNTIL TMS CERTIFICATE
HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide 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..
Existing single-family and multi -family dwellings shall be provided. with Smoke Alarms and Carbon
Monoxide alarms. Mien 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 in the following locations:
AREA
SIV OKE CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X X
On every level of a dwelling unit including basements
X X
LWithin each slee2fng room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -bunting 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.
Z:�� -
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 CRC Section R31.4 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alai ms which 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 iri 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.
I have read and aarea to comniv, with the terms end rnnditinn-c �nf this .Qt.QtAmPnt
Owner (or Owner Agent's) Name:
Docuftned by:
Anshuman-Naftarni
... . ... I ....................... ................ ..... Dat;/D/N;
Contractor Name-
023GFG6A8316460
nature. . ........................ . ............................... ......Lica..................... ....... Date; ..........
Smoke and Wfortn,doc revised 03118114
.7
DocuSign Envelope ID: F17C7248-F629-4A17-9015-F65F696lD385
CUPERTINO
WATER-CONSERViNG PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE . CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - buildingAcui3ertino.orcl
Owner Name AnShuman Nadkarni permit No. B-2016-3284
Address 6283 Shadygrove Court, Cupertino, CA 95014
PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE
.HAS BEEN SIGNED AND REnMNED TO THE BUILDING DIVISION
Please refer to the attached California Civil Code Sections 1101.1 - 1101.8 which are part of this Certification form.
I . is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature:DoeuSignedby: Date: 1/23/2017
13 No Go to Question 2.E023CFC5AS316460
Vt,SU,l�un�taln,N&Aa vi
...
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
plumbing, installation of water -conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
Sign below and skip the rest of the form.
DocuSigned by: 1/23/2017
Owner' Signature:lIn,SA Na� Date:
L� No Go to Question 3.
023CFC5A8318480...
3. is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature:DocuSigned by: Date: 1/23/2017
13 No Go to Question 4. QvoLwoln, Nq,AmAi
023CFC5AB316460...
4. is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No My 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. Sign below and skip the rest of the form.
DocuSigned by:
Owner' Signature: QtaS"., Na" Date: 1/2 3/2017
12 Yes My real property i'WWAamailublc for use or occupancy on or before January 1, 1994.
Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached.
❑ My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014, building alterations or improvements shall require all non-compliant 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 plumbing fixtures (regardless
of whether property undergoes alterations or improvements).
❑ My property is a nzultifamily residential real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
SB407 2015.doc revised 02104115
ObcuS'rgnEnvelope ID: F17C7248-F629-4A17-9015-F65F6961D3B5
A
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
I/We, the owner(s) 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 1101.1 through
1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation
reauirements. and that the water-conservtr&trft*i1bimz fixtures comniv with the reauirements as indicated in the table below.
Owner's (or Owner Agent's)
Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit.
1. if the existing plumbing fixture water usage/flow rate is equal to or lower tnan the ngure shown, it is not rcguucu w uo uYip
SB407 2015doc revised 02104115
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixturel
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
/Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush
Gallons/flush
Showerheads
Exceed 2.5
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets —
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 psi
Faucets —
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
minute @ 60 psi, and must
gallons per minute @
default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
reduction.
1. if the existing plumbing fixture water usage/flow rate is equal to or lower tnan the ngure shown, it is not rcguucu w uo uYip
SB407 2015doc revised 02104115