B-2017-0208 1
CITY OF CUPERTINO BUILDING*ERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0208
7600 RAINBOW DR CUPERTINO,CA 95014-5247(366 11 037) SOLARCITY
CORPORATION •
SAN MATEO,CA 14402
OWNER'S NAME: CHAN NORMAN AND VIRGINIA I DATE ISSUED:02/02/2017
OWNER'S PHONE:408-718-2090 1 PHONE NO:(650)963-5100
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-10:C-46 Lic.#888104
Contractor SOLARCITY CORPORATION Date 12/31/2018 X BLDG _ELECT _PLUMB
MECH X RESIDENTIAL_COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing — 1
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
(N)14-PANEL ROOF MOUNTED PV SYSTEM(4.41 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..,,,,i ,,r,„.....LI have and will maintain Worker's Compensation Insurance,as provided for by
N- Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area:j Valuation:$8000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above I
information is correct.I agree to comply with all city and county ordinances APN Number: 1 Occupancy Type:
and state laws relating to building construction,and hereby authorize 36611 037
representatives of this city to enter upon the above mentioned property for j
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 ap•licant understands and will comply with all non-point
source regulatio •ern the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
^
'_.Signature - ‘-"A----- Date 2/2/2017 Issued by:Abby Ayende
il Date:02/02/2017
OWNER-BUILDER DECLARATION
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 roofmg material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without fist obtaining an inspection,I agree to remove all new materials for
i
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:2/2/2017
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
s. 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 Cuperjlino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,:ec ions 1(5505;2553 an 4.
Labor Code,I must forthwith comply with such provisions or this permit shall c _
be deemed revoked. Owner or authorized agent oe,u c
APPLICANT CERTIFICATION Date:2/2/2017
I certify that I have read this application and state that the above information is CONSTR TION 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. I understand my plans shall be used as public records.
Licensed
Signature Date 2/2/2017 Professional
\enik/ ALTERNATIVE ENERGY PERMIT APPLICATION AE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
�yt,,9ss 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•building cx,cupertino.or ,
eL
PROJECT ADDRES ,-.“00.140_,i-. ' �s q /� ¢� APN#3 Ce %_, —1 I — 0 3
OWNER NAME. e �lJ PHONE a/ .1, , 1°/v E I 11 �49) fri 0_01
STREET ATS)., •Li 1& o IJ &✓iSAT �F040l �� 1 FAX
CONTACT NAMEGerry IgtanloG PHONE 650-759-8042 E-MAILgigtanIoc@solarcity.com
STREET ADDRESS 391 Foster City Blvd. CITY,STATE,ZIP Foster City,CA,94404 FAX
❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTRACTOR 0 CONTRACTOR AGENT 0 'ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME SolarCity Corp. LICENSE NUMBER 888104 LICENSE TYPE
Cl0,C46 BUS.LIC fit 28844
COMPANY NAME SolarCity Corp. E-MAILgigtanloc@solarcity.com . FAX
STREET ADDRESS 3055 Clearview Way CITY,STATE,ZIP San Mateo, CA 94402 PHONE 650-759-8042
ARCHITECT/ENGINEERNAME LICENSE NUMBER v BUS.LIC
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND PROJECT IN
STRUCTURE: 0 Commercial URBAN INTERFACE AREA 0 Yes 0 No FLOOD ZONE 0 Yes 0 No
AR PANELS 0 ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER:
FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATi%
15 1
DESCRIPTION OF WORK
Install ( 14 ) rooftop mounted solar panels,( 4! ) KW
RECE
signature below,I certifyto each of the I am the roe owner or authorized agent to act on the property owner OLIVA
I have read this
By my following: property rtY
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 buildi construction_I-authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: 2.4
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SUPPLEMENTAL INFORMATION REQUIRED otFICE USE ONLY
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PVApp 2011.doc revised 03/16/11
CUPERTINO
PURPOlb t
SMOKE / CARSON 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 • buildinoBcunartinn-orn
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with. 2016 CRC Section R314, R315, 2016 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, R315, 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
I SMOKE ALARM
CO ALARM {
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door)..
X
X
On every level of a dwelling unit including basements and habitable attics
X
XXX
Within each sleeping room
X
J
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burnhag 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.
Iii 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 CSC Sections 907.2.11.4 and 420.6.2 -Ah 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 alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and i11 compliance with the California Building
and California Residential Codes. The alarms specified below have been tested and are operational, as of the
date sib led below.
Address: 98,011120W CoP�'I 1 ENO CA 41 14 Permit No. 6q
Specify Number of Alarms: r Smoke Alanils: r Carbon Monoxide Detectors:
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
Aloellh&A
Signature . e ... �J........ M•:c:: .iG m%„ ...............Date
Contractor Name:
Signature.. ................................................................ Lic.# ......................................Date:..................
S»roke and W f07777.doc revised 01/1012017
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE -
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPEATIN
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 building(a�cupertino.orq
Owner Name L 'll �P''h 6410 Permit No.
Address V0 WNl 6,0 , ruprh, 'T -T('16 014
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No Go to Question 2. �.
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.
Skip the rest of the form and sign bottom of form.
Y\No Go to Question 3.
3. Is water service permanently disconnected for your building?
El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No Go to Question 4:
Ale
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. Skip the rest of the form and sign bottom of form.
L; Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form._
5. Please check ONE of the following:
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 withwater-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 multifamily 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.
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, as the owner or owner's agent 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 -conserving plumbing fixtures comply with the requirements as indicated in the
table on the following page. t*L J), "° C/.c &ja_ -___
Owner or Owner Agent's Signature: Date: 0711 D' Zg 7
Upon completing and signing this Certiticate, please return it to the t5wiamg Invision in oraer to nnai your ounanig PciuuL.
SB4072015.doc revised 08/26/15