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B-2017-0179CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0179 23646 BLACK OAK WAY CUPERTINO, CA 95014-6557 (342 56 017) WILLOW GLEN ELECTRIC INC SAN JOSE, CA 95155 OWNER'S NAME: 13APAT SYEKHARAND NIVEDITATRUSTEE DATE ISSUED: 01/30/2017 OWNER'S PHONE: 650-776-6796 PHONE NO: (408) 289-9725 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic. #591918 Contractor WILLOW GLEN ELECTRIC INC Date 04/30/2018 X_ BLDG —ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapte � 9 (commencing 1VIECH X RESIDENTIAL COMMERCIAL with Section 7000) of Division 3 of the Business & Professions G Ae and that my license is in full force and effect. JOB DESCRIPTION: (N) EV CHARGING STATION (50 AMPS) - GARAGE 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 DSection 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $1140.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 342 56 017 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 per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signaturejfe/`" l/�Rii �� Date 01/30/2017 Issued by: Kim Dunbar OWNER-BUILDER DECLARATION Date: 01/30/2017 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 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 (Scc.7044, Business & Professions Code). Date: 01/30/2017 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 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 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 waking 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 X505, 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: 01/30/2017 I certify that I have read this application and, state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending 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 DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed SiSignature Date 01/30/2017 g Professional 94PA,f I ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT, BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3256 A (408) 777-3228 - FAX (408) 777-3333 0 PROJECT ADDRESS _7 APN # 71 - OWNER NAME <3 t ab PI ON rC cu STREET ADDRESS a36110 5LA(t& VAA. ZSTA CA FAX CONTACT NAMEE-MAILMark Londre PHONE (408)289-9725 office@willowqlenelectric.com STREET ADDREs"R 0, Box 8430 CITY, STATE, ZIP San Jose, CA 95155 FAx (408)289-9725 11 OWNER El OWNFR-BUILDPR I-] OWNER AGENT VCONTRACTOR 11 CONTRACTOR AGENT El ARCHITECT 11 ENGINEER 1:1 DEVELOPER E3 TENANT CONTRACTORNAME Mark Londre LICENSE NUMBER 591918 LICENSE TYPE C-10 Bus -Lc" 15897 COMPANY NAME Willow Glen Electric, Inc. E-MAIL office@willowglenelectric.com FAx (408)289-9725 STREET ADDRESS R 0. BOX 8430 CITY, STATE, ZIP San Jose, CA 95155 PHONE (408)289-9725 ARCHITECT/ENGINEER NAME N/A LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL - FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duple, El Multi Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA [I Yes 0 No PROJECT IN FLOOD ZONE ❑ Yes [3 No ❑ SOLAR PANELS 10 ELECTRIC VEHICLE CHARGING STATION q SOLAR WATER HEATING ❑OTHER: FOR SOLAR PANELS. NUMBER OFPANELS/UNrrS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION] A 1', DESCRIPTION OF WORK Electric Vehicle Char ging Circuit: i��F-A-43&t "° Im SnAcL_ jV V .,I-C4vP btZI(Al-CF-bC-02-01111-tr A /L)01,tA 14-5-0 1 11 C_ A-6 0 &_4 Aa& D &Z 5 RE B 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 provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constr' I RA ,0jizqtepres ves of Cupertino to enter the above -identified property for inspection purposes. Signature of Applioant/Agent: Ae. Date: SUPPLEMENTAL INFORMATION REQUIRED opx fm USE ONLY OVER-TH&COVINTER STANDARD' -LARGE MAJOR PVApp, 201 Ldov revised 03116111 DocuSign Envelope ID: D999245A-B149-4EEC-AC39-E230E9AE44AD • SMOKE/ CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cupertino.ora Permit No. B-2 017-0179 Address 23646 Black oak way #of Alarms Smoke:7 Carbon Monoxide: 2 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS 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. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When 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 SMOKE ALARM 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 includingbasements X X Within each slee ping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning 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. 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 8314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarn-i(s) referenced above has/have been installed in 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. ' f have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: _ D,ocuasiigned� by: shekhar Ba at si natur .,.5,.iJ. .Dat Contractor Name: 8912DCDC9B68416... signature........... ........... ............... .............................. Lic.#...................................... Date:................... Smoke and C©fnrm.doc revised 03118114 .7 UocuSign Envelope ID: D999245A-8149-4EEC-AC39-E230E9AE44AD 64WANUM COMMUNITY DEVELOPMENT DEPARTMENT; BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinclCakupertino.org OwnerName shekhar Bapat permit No. B-2017-0179 Address 23646 Black Oak way, Cupertino, CA 95014 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNLL! AND RETLIMD TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 - 1101.8 which, are part of this Certification form. 1. Is your real property a registered historical site? - F] Yes Civil Code Sections I 10 1. 1 through 1101,8 do not apply. Sign below and skip the rest of the form.- Owner' Signature:DocuSigned by: Date: 2/10/2017 NO Go to Question 2. bafat E� 8416 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? D Yes Civil Code Sections 1101.1 through 1101.8 donot apply. 01 The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. Owner' Signature: DocuSigned by: Date: 13 2/10/2017 No Go to Question 3. LLLV 15 0f A� - Es8912DCDC9B68416--, 3. Is water service permanently disconnected for your building? 0 Yes Civil Code Sections 1101,1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature D S' db Date: 2/10/2017 13 No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 9 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. e-- DocuSigned by: Owner' Signature: Date..2/10/2,017 1-1 Yes My real property iiltamdcamiisble for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. 0< 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). 0 My property is a nuiltifamily 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). 0 My property is a coniniercial 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.dac revised 02104115 DocuSign Envelope ID: D999245A-8149-4EEC-AC39-E230E9AE44AD 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). 1/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 requirements, and that the water-conscTvi*tvh0hbIap, fixtures comely with the requirements as indicated in the table below. Owner's (or Owner Agent's) uo��nrnroQaun�c 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 usagelflow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 20152oc revised 02104115 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture/ (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 si 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 usagelflow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 20152oc revised 02104115 Install one 240 Volt 50 Amp dedicated circuit with a NEMA 14-50 Shekhar Bapat receptacle in the front left corner of the garage directly behind the 23646 Black Oak Way; outdoor main electrical panel for EV charging. This circuit will Cupertino, CA. 95014 provYfe'CEIVED 0 continuous amps for charging. (650) 776-6796 200A Mc w/ 50A t Driveway CUPERTINO Building Department JAN 3 0 2017 REVIEWED FOR CODE COMPLIANCE Reviewed By-. C� .-t Shekhar Bapat Page I �y JG 31i E _ 01 o C. _. 0"T017 9 Residential Electrical Load Calculation - REMOVE 30A AC BREAKER Site Location: Prepared by 1 L L 0 W Shekhar Ba pat Willow Glen Electric, Inc. L H N 23646 Black Oak Way PO Box 8430 LBC 7 R I C Cupertino, CA. 95614 San Jose, CA SS 155 (650) 776-6796 (408) 289-9725 - office General Lighting and Receptacle Loads 122oaz] 3 watts per ft' x 3,786 - 11,358 Small -Appliance Branch Circuits [220.52(A), 210.1(C)l1)) 1,500 watts x 2 = 3,000 Laundry Branch-Circult(s) [220.52(B), [210,11(C)(7.)] 1,500 watts x 1 - 1,500 15,858 Fastened -in -Place Appliances Kitchen Baths) Outlsde/Miscellaneous [220.531 Refrigerator(s) = 780 Instant Hot H20(s) = 480 Exhaust Fan(s) = Hot Tub = Dishwasher(s) = 950 Hood Exhaust(s) = JacLzzl Tub(s) = 1,920 Pool Equipment = Garbage Disposal(s) = 600 Gas Range(s) = Radiant Heating = Central Vacuum = Microwave(s) = 1,200 Gasoven(s) = Steam shower = Sewage Elector = Trash Compactor = Wine Fridges) = Sauna = 30A Clrcult = Steamer = _ = Garden Shed = Total Fastened -In-place Appliance Load 5,940 Clothes Dryers) [220.541 80% x 240 x Derating Volts Amps 5,000 OR Name Plate Rating of Clothes Dryer = 5,00D Ranges, Ovens, Cooktops, and Other Household Cooking Appliances 1220.551 80% x 240 x 50 - 9,600 ' Derating Volts Amps AND/OR Name Plate Rating of ceoking 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 5,970 55% x 240 x 40 = Derating Volts Amps AND/OR Name Plate Rating of Air Handler & AC Units = Total Volt -Ampere Demand Load )220.83] Greater of., Air-conditioning Equipment 5,970 x 100% = 51970 Electric Space Heating - x 100% = First 8kVA of all other loads 8,000 x 100% = 8,000 Remainder of all other loads 28,398 x 40% = 11,359 25,329 Total Current Minimum Amperes 25,329 + 240 = 105.5 Current Minimum 200 Amps (voltage) (minimum amperes) 17 Size Service or currently Electric Vehicle [625.141 I f" 000 125% x 240 x SB = Continuous Load Volts Amps Minimum Amperes with Added ad Minimum Size Divide the total .49,32®.+ 240 = X09:4' J(pg 20 Service or Feeder 200 Amps volt-amperes by till 7 �D (voltage) (minimum amperes) w/ Added Load with added load the voltage. ! [240.6(A)l NOTES All References are to 2014 National Electrical Code, �> 1190 117 - O/VM.., i + CUPERTIIVC; Building Depatrlent JAN 302017 REVIUAIED FOR COBE COMPLIANCE t�eviewed By: INSTALLING YOUR 240 VOLT OUTLET The recommended home charging Instal latlon for Tesla vehicles Is a 240 volt NEMA 14- 50 outlet. This outlet Is commonly used for electric ranges and large recreational vehicles, Installed with a 50 -amp circuit breaker, this outlet enables a recharge rate of about 26 miles per hour. Consult a licensed electrician to review the electrical load of your home prior to Installation. They will design your charging system and obtain a permit for a general Purpose NEMA 1450 outlet from your local building department. After Installation, the electrician will schedule an Inspection to approve the new electrical circuit and design. This guide provides reference for specifications to Install this outlet. Since each installation Is custom to the home, all hardware for the NEMA 14.50 outlet will be provided by your electrician. GROUND TO Top I G zscly NEMA 14-50 DETAILS • Voltage: Single phase, 208-250 volt AC supply, 60 hertz • Circuit Breaker: 50 amp (126% overcurrent protection) • Operating Current, 40 amp (maximum continuous current) • Conductors: 6 AWG, Copper Wire Only. Upsixe wiring for Installations over 1 S feet • Ground Fault Circuit interrupter Not required ® Service Disconnect: Not required ° Receptacle Ftecommenclatfon: Nigh quality, Industrial grade receptacle Examples: Hubbell part # H13l.940A, Cooper part #6754N ° Ventilation: Not required • Outdoors: Install with NEMA 3R rainproof enclosure RECOMMENDED LOCATIONS CHARGE PORT RECOMMENDED LOC fJON Fop 240 VOLT T=—ZLn ADDITIONAL RESOURCES EMAIL C:i 1AI,zGINCINISTALLATI0N@)'i-ESLA,COM PHONE Ila 24/7 TECH SUPPOPT. :"°tldln9 877.798.3752 WEB 'rESL.A.00M/SlJPIDCiCUM' ONLINE STORE Sl-I0P."u'.:SI.,A,('0vi 45500 Fremont Boulevard, Fremont, CA 94538 1 May, 2016 1 Veralon 3