B-2017-03824 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:.
19445 PHIL IN CUPERTINO, CA 95014-3429 05 036)
CONTRACTOR:
PERMIT NO: B-2017-0382
(375
SUNRUN
INSTALLATION
SERVICES INC
SAN LUIS OBISPO, CA
93401
OWNER'S NAME: YANG HEE HONG AND PARK KYOUNG JA YANG
DATE ISSUED: 03/08/2017
OWNER'S PHONE: 408-914-1732
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
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— MECH X RESIDENTIAL — COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
(I) 17-PANEL ROOF MOUNTED PV SYSTEM (4.5 KW)
I hereby affirm under penalty of perjury one of the following two declarations:
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.
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
permit is issued.
Sq. Ft Floor Area:
Valuation: $9045,00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
"N 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
375 05 036
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 nsequeof the granting this permit.
Additionally, the applicant n rs nds andd will comply with all ll non-point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per a pe ino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 3/8/2017
Issued by: Y A Abby gnde
.'L.
OYMR_ TI
Date: 03/08/2017
6-11
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 (Sec.7044, Business & Professions Code).
Date:/83 /2017
1 hereby affirm under penalty of perjury one of the following three declarations:
1. I have and will maintain a Certificate of Consent to self insure for Worker's
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
i. 1 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
Worker's Compensation laws of California. If, after making this certificate of
air contaminants as defined by the Bay Area Air Quality Management District I
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, Se tions 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: 17
1 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 and state laws
I hereby affirm that there is a constr do lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is iss a (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.
Signature Date 3/8/2017
Licensed
3_zu_�-- 03 2
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@-cupertino.org
PROJECT ADDRESS 19445 Phil Lane
APN# 37505036
OWNERNAME Heehon Yang
g g
PHONE
(408) 914-1732
E-MAII,
h2yanghh@gmail.com
STREETADDRESS 19445 Phil Lane
CITY, STATE, ZIP Cupertino, CA 95014
FAX
CONTACT NAME Vance Jason
PHONE (408) 506-3693
E-NLAIL vance.jason@sunrunhome.co
STREETADDRESS SAME AS CONTRACTOR
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT
CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Sunrun
LICENSE NUMBER 750184
LICENSE TYPE C-46
BUS. LIC# 27932
COMPANY NAME
Sunrun
E-MAIL
FAX
(408) 894-9294
STREET ADDRESS 575 Dado St
CITY, STATE, ZIP San Jose, CA 95131
PHONE (408) 747-2487
ARCHITECT/ENGINEERNAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF E/SFD Or Duplex ❑ Multi -Family
PROJECT IN WILDLAND
PROJECT IN
STRUCTURE: El Commercial
1
URBAN INTERFACE AREA El Yes lN/ NO
FLOOD ZONE ❑ Yes ❑ NO
SOLAR PANELS
❑ ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER HEATING
❑ OTHER:
FOR SOLAR PANELS: NUMBER OF PANELSIUNITS: 17
KILOWATTS (COMMERCIAL ONLY):
TOTAL VALUATION: $9045.00
V�
DESCRIPTION OF WORK 4.5 kW PV (17) MODULE SOLAR ROOFTOP INSTALLATION
REGEIVED-BY:
By my signature below, I certify to each of the follo
am the property owner or authorized agent to act on the property owner's be lf. I halve read this
application and the information I have rov�ded i ect
have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating toit ' g c cti .
I authorize representatives of Cupertino to enter the above -identified p operty for pection urposes.
n
Signature of Applicant/Ag
Date:
SUPPLEr INFORMATION REQUIRED
OFFICE USE ONLY
❑ OVER-THE-COUNTER
a
❑ EXPRESS
A
❑ STANDARD
U
❑ LARGE..
'a
a
.
i',��^�
❑ MAJOR
PVApp 2011.doc revised 03/16/11