14060202CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7791 LILAC WAY
CONTRACTOR: VIVINT SOLAR
PERMIT NO: 14060202
DEVELOPER LLC
OWNER'S NAME:
SAN JOSE, CA 95131
PHONE NO: (855) 877 -2974
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
INSTALL 17 FLUSH MOUNTED PV PANELS (4.335 KW)
� Lyicy., # q 73 75-4-
License Class` Oh-
Contractor Viy/ Y* sNoY Vey Date U 1
I hereby affirm that 1 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.
I hereby affirm under penalty of perjury one of the following two declarations:
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
Sq. Ft Floor Area:
Valuation: $21675
VN!
performance of the work for which this permit is issued.
1 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
APN Number: 35904010.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. 1 agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS" ISSUANCE OR
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to building construction, and hereby authorize representatives of this city to enter
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upon the above mentioned property for inspection purposes. (We) agree to save
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Ti
1 DAY T
S AS LLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,
�' P Y P g judgments,
costs, and expenses which may accrue against said City in consequence of the
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granting of this perm Additionally, he a cant understands and will comply
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with all non -point u ce regulations per upertino Municipal Code, Section
9.18.
rr°ARE-ROOFS:
Signature Date W �t) 1�
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ WNER- UILDER DECLARATION
Signature of Applicant'. Dale:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the stricture is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self- insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as derined by the Bay ea Air Quality Management District 1
performance of the work for which this permit is issued.
will maintain compliance with the Cu ert no Municipal ode, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 5505, 25533, and 7634.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Da te: 6
permit is issued.
I certify that in the performance of the work for which this permit is issued, 1 shall
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not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
CONS U ION NDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. 1 agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnity and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
1 understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
n/Ctrlrt_ Ptr_ ). ThPCP fevc arP ha.CPd an the nrPliminary infnrmatinn ovailahle and are nniv an estimate Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolzdion 11 -053 Ef, 7/1:73)
ADDRESS: 7791 LILAC WAY
DATE: 06/30/2014
REVIEWED BY: MELISSA
MISC ITEMS
APN: 359 04 010
BP #: �_,� w�
`VALUATION: $21,675
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
Alternative Energy System
1PHOTOVRES Photovoltaic System
PENTAMATION SOLAR -RES
PERMIT TYPE:
WORK
INSTALL 17 FLUSH MOUNTED PV PANIELS 4.335 k
SCOPE
_._..
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
n/Ctrlrt_ Ptr_ ). ThPCP fevc arP ha.CPd an the nrPliminary infnrmatinn ovailahle and are nniv an estimate Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolzdion 11 -053 Ef, 7/1:73)
FEE
QTY /FEE
MISC ITEMS
Plan Check Fee:
$0.00
0 #
$229.00
Alternative Energy System
1PHOTOVRES Photovoltaic System
Suppl. PC Fee: 0 Reg. Q OT
FO.0
his
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-.0 Reg.
0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
Building or Structure
0
i
Strong Motion Fee:
IBSEISMICR
$2.17
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$3.17
$229.00
TOTAL FEE:
1 $232.17
Revised: 04/01/2014