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B-2017-0469 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0469 10159 S FOOTHILL BLVD CUPERTINO,CA 95014-2601(342 14 117) SOLARCITY ' CORPORATION SAN MATEO,CA 94402 OWNER'S NAME: TANEJA VAIBHAV AND KOMAL DATE ISSUED:03/23/2017 OWNER'S PHONE:408-448-0140 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 X 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: (N) 18-PANEL ROOF TOP PV SYSTEM(5.67 KW);NEW SUB-PANEL I hereby affirm under penalty of perjury one of the following two declarations: (125 AMP) 1. I have and will maintain a certificate ofconsent to self-insure for Worker's REV#1-DOWNSIZE TO(5.525 KW);(17)PANELS-ISSUED 4/28/2017 Compensation,as provided for by Section 3700 of the Labor Code,for the REV#2-ADD 2 STORAGE SYSTEM BATTERY(26 KW)-ISSUED .erformance of the work for which this permit is issued. 6/7/2017 have and will maintain Worker's Compensation Insurance,as provided for by REV#3-UPGRADE PANEL(125 AMP). ISSUED 8.18.17 --. Section 3700 of the Labor Code,for the performance of the work for which this REV#4-RELOCATE ALL EQUIPMENT TO` NTERIOR TO GARAGE- permit is issued. ISSUED 10/5/2017 APPLICANT CERTIFICATION Sq.Ft Floor Area: Valuation:$13000.00 I 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 relating to building construction,and hereby authorize APN Number: Occupancy Type: representatives of this city to enter upon the above mentioned property for 342 14 117 inspection purposes. (We)agree to save indemnify and keep harmless the - — City of Cupertino against liabilities,judgments,costs,and expenses which maylly against said City in stands and e of the hg othis PERMIT EXPIRES IF WORK IS NOT STARTED Additionally,the applica t understands and will comply with all non-point source regulans per e Cuse.ale L unicipal Code,Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR atur i 1 N'14�L�` Date 10/5/2017 180 DAYS FROM LAST CALLED INSPECTION. Issued by:ABBYAYENDE OWNER-BUILDER DECLARATION Date:03/23/2017 I hereby affirm'that I am exempt from the Contractor's License Law for one of the following two reasons: RE-ROOFS: 1. I,as owner of the property„or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installed.If a roof is compensation,will do the work,and the structure is not intended or offered for installed without first obtaining an inspection,I agree to remove all new materials for sale(Sec.7044,Business&Professions Code) inspection. 2. I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). Signature of Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 10/5/2017 i. 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance,as provided for by HAZARDOUS MATERIALS DISCLOSURE Section 3700 of the Labor Code,for the performance of the work for which this I have read the hazardous materials requirements under Chapter.6.95 of the permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will . 3. I.certify that in the performance of the work for which this permit is issued,I maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the, shall not employ any person in any manner so as to become subject to the Health&Safety Code,Section 25532(a)should I store or handle hazardous Worker's Compensation laws of California. If,after making this certificate of material. Additionally,should I use equipment or devices which emit hazardous exemption,I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I Labor Code,I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,,ectionp 25505,25 33,and 25534. be deemed revoked.%, APPLICANT CERTIFICATION err ®Owner or authorized agent: --�.tft��_ �j!\ I certify that I have read this application and state that the above information is Date: 10/5/2017 correct.I agree to comply with all city and county ordinances and state laws CONSTRUCTION LENDING AGENCY relating to building constructior,and hereby authorize representatives of this city [hereby affirm that there is a construction lending agency for the performance to enter upon the above mentidried property for inspection purposes. (We)agree of work's for which this permit is issued(Sec.3097,Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands Lender's Address and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. -j, ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 10/5/2017 Licensed Professional 13- lots _ ceq ,Nii ALTERNATIVE ENERGY PERMIT APPLICATION (.410)„, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION AE , 7 t,„,>, 10300 TORRE AVENUE•CUPERTINO,CA 96014-3285 CUPERTINO (408)777-3228•FAX(408)777-3333•buildin.Qa.Gupsrtino.oT PROJECT ADDRESS c 0 i5t7 s r c9 m` -1,l L 61 v APN II 6.12•._1 c�"11`�—' OWNER NAME `11ti i .t')4AV T q PHONE Coop_y40,ol(,�EIuIAIL7���,A....441,�v (iya(ng sTRBBTAD R F J L U `Q CITY,STATE ZIP oce.7,..„,..A. , FAX CO-N._ CONTACT NAMEEMAIL Gerry Igtanloc PHONE 650-759-8042 gigtanloc@solarcity,com STRBETA'DS391Foster City Blvd. CITY STATE,ZIP Foster City,CA,94404 FAX O OWNER 0 OWNER-BUILDER y 0 OWNER AGENT il CONLRACTOR ❑CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR ESolarCity,Corp. LICENSE NUMEER888104 LICENSETYPEC1O,C46 BUS.LI"28844 COMPANY NAMES H MAIL FAX olar City'Corp. gigtanloc@solarcity.com STREET ADDRESS 3055' Clearvieviw.Way '1'4 STATE.ZIP San Mateo!, CA'94402 .FRGNE650-759-8042 ARCFBTECT,BNOINEERN 'AME sLICENSBNUMBER sus.LIC# COMPANY NAME EMAIL 4 FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OP 0 SFD or Duplex' 0 Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA 0 Yes 0 No FLOOD,ZONE 0 Yes ❑ No ' i. ❑SOLAR PANELS 0 ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER: , FOR SOLAR PANELS: 'NUMBER OF PANELSIUN1TS: KILOWATTS(COMMERCIAL ONLY): TOTAL;VALUATION 000 00 DESCRIPTION OF WORK " I 'l Install ( 1 )-- ) rooftop mounted solar paneis,(c.5- ,'KW -1- Z6 k ui 7c9 A (71� S s T-- - Ci5A11-bi) / RECEIVED BY:01-(i., Cu `OA f ) By my signature below,I certify to each of the following: I em the property owner or authorized agent to act on the property owner's behalf. I havb read this application and the information I have. .vided is correct. I have read the Description of Work and verifj It is accurate. I ire to comply with all applicable local ordinances and state laws relating to r i. �nNnn-r-.110..07A-Anreseetatives of Cupertino to enter the abovA-m.n ^�^"^ f,;nspaohon purposes, Signature ofApplicant/Agent:._ ii ®t; �> ---- . ---- Date: ..)6 °5, I SUPPLEMENTAL INFORMATION I QUIRED l _ OFFICE USE ONLY J 9.S'\2(� VO \(\-`e'C of '''''i D ovETs.Tal otrHTsx C,�0�J p �c ❑ EXPRESS tke!.-t Q'*C Q)4���6( �*c El STANDARD In LARGE , a. . ❑ MAJOR 1 PT/Ann 2nll.dnr.ravfcadO3/1fin 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0469 10159 S FOOTHILL BLVD CUPERTINO, CA 95014-2601 (342 14 117) SOLARCITY CORPORATION SAN MATEO, CA 94402 I OWNER'S NAME: TANEJA VAIBHAV AND KOMAL l I DATE ISSUED: 03/23/2017 l OWNER'S PHONE: LICENSED CONTRACTOR'S DECLARATION License Class C-10 Lic. #888104 Contractor SOLARCITY CORPORATION Date 12/31/2018 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. 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 have and will maintain WoikieI Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT. RTIFICATION I certify that I have read this applicatin, and state that the above information is correct. I agree to corriply'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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant -understands and will comply with all non -point source regulion perAhe Cupertino Municipal Code, Section 9.18. Signature :. `" Date 8.18.17 I hereby affirm. that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the propert}; or my employees with wages as their sole compensation, will.do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property am exclusively.contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). Thereby 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 Compensation,- asprovided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2. I have and willmaintain 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.' 3. I certify that'Irithe peiformance of the work for which this permit is issued, I shall, not employany; person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, Ilbecome subject to the Worker's Compensation provisions of the Labor Code, iI-musfforthwith comply with such provisions or this permit shall be deemed'revoked. I certify that I have readthis application and state that the above information is correct. I agree to complywithl 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 indemnify and,kee,p harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit.' Additionally, the applicant understands and will comply with all,non-point source regulations per the Cupertino Municipal Code, Section 9.18. ' Signature Date 8.18.17 PHONE NO: (650) 963-5100 BUILDING PERMIT INFO:' 3X BLDG YX ELECT _ PLUMB _ MECH 3X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (I) 18 -PANEL ROOF TOP PV SYSTEM (5.67 KW); NEW SUB -PANEL (125 AMP) REV#1 - DOWNSIZE TO (5.525 KW); (17) PANELS - ISSUED 4/28/2017 REV #2 - ADD 2 STORAGE SYSTEM BATTERY (26 KW) - ISSUED 6/7/2017 �r 2511 1Pf11I.5 Sq. Ft Floor Area: l Valuation: $13000.00 APN Number: Occupancy Type: 34214 117 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: SEAN HATCH Date: 03/23/2017 RE -ROOFS: 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. Signature of Applicant: Date: 8.18.17 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous 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 the Health & Safety Code, S tions 505, 25533, and 25534. Owner or authorized agent: F Date: 8.18.17 CONSTRUCTION LENDING ENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address 'ARCHITECT'S• D RATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 0 (408) 777-3228 • building@cupertino.org PEMIT #B - 10/7 - CVPERTINO REV# DEF# [:]NEW CONSTRUCTION ❑ ADDITION R ALTERATION ❑ T.I. 0 MEP ❑ RE -ROOF ❑ SWIMMING POOL/SPA PROJECT ADDRESS Lo15 r i9W6 APN # .AME -7-14�� PHONE E-MAIL STREET ADDRESS uI ,d S >SLJ/J CITY, STATE, ZIP eaop((5�( /J0 Q-4 7 2CDNTRACTOR NAME ❑ OWNER -BUILDER COMPANY NAME LICEN E NUMBER LICENSE TYPE STR��i R� ESS CITY IP E-MAIL CCt� "() Cd to d'Gf7 Caq PHONE BUS. LIC # _ S - -'90CC L RCHITECT , OWNER ❑ OWNER AG ❑ CONTRACTOR AGENT El ENGINEER ❑ DEVELOPER ❑ TENANT CON JACT NAME E-MAIL STREET ADDRESS CITY, STATE, ZIP PHONE DECRIPTON INGLE-FAMILY/DUPLEX ElMULTI-FAMILY[IINDUSTRIAL ❑ COMMERCIAL USE TYPE OCC SQ.FT. VALUATION ($) EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES # TOTAL NET SF REMODEL '.REMODEL KITCHEN REMODEL OTHR GARAGE ❑ ATTACHED BATHROOM SF SF SF SF ❑ DETACHED EXISING ❑YES EICHLER YES! SECONDSTORYADDITION OYES SPRINKLERS NO El ❑❑ NO NO DWELLING SECOND DWELLING 'YES ❑'ATTACHED❑DETACHED OTHER ' UNITS # UNIT ADDrTON: ❑;NO . ' SF POOLS ❑ FIBERGLASS ❑ VINYGLINED'i ❑ GUNITE ❑ PREFABRICATED POOL - SF SPA - SF SPA ATTACHED ❑ YES N NO TOTAL - SF Cmnmacial or Multi-Fmn4u Buildings_ with. Public�Swimmine Pools requires Department of Environmental Heath approval RECEIVED By TOTAL ON: RE -ROOF EXISTING ROOF TYPE:, ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES'❑ WOOD SHINGLES ❑ TILE OTHER (SPECIFY)' REMOVE /REPLACE NO IF NO PLYWOOD ❑'� ❑ 3/8" PLYWOOD TYPE: PITCH: ROOF CLASS YES I # OF LAYERS THICKNESS ❑ 5/8" OTHER ❑ OSB ElCDX OTHER 12 A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER *Provide a signed copy of the Cupeitino's Tear -Off Policy SF #of SQUARES 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 iiiformation 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 construction. I authorize representatives of Cupertino to enter the above -identified property for ' pection p o es.., adknowledge and authorize all information contained n this application form to be made available for public record. �� r Signature of Applicant/Agent: Dater SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide,a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval,Letter or Meeting with Planning prior to submittal.of Building Permit application. � *HOA -Provide a letter of approval from the Home Owner's Association BldgApp_20 17. doe revised 08101117 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0469 10159 S FOOTHILL BLVD CUPERTINO, CA 95014-2601 (342 14 117) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: TANEJA VAIBHAV AND KOMAL DATE ISSUED: 03/23/2017 OWNER'S PHONE: 408-448-0140 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 X 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: (N) 18 -PANEL ROOF TOP PV SYSTEM (5.67 KW); NEW SUB -PANEL I hereby affirm under penalty of perjury one of the following two declarations: (125 AMP) 1. I have and will maintain a certificate of consent to self -insure for Worker's REV#1 - DOWNSIZE TO (5.525 KW); (17) PANELS - ISSUED 4/28/2017 Compensation, as provided for by Section 3700 of the Labor Code, for the REV #2 - ADD 2 STORAGE SYSTEM BATTERY (26 KW) - ISSUED performance of the work for which this permit is issued. 6/7/2017 � j7—L.have and will maintain Worker's Compensation Insurance, as provided for by �J Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $13000.00 permit is issued. APPLICANT CERTIFICATION I 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 342 14 117 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 regulation r the C ino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature / Date 6/7/2017 Issued by: MELISSA NAMES OWNER -BUILDER DECLARATION Date: 03/23/2017 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 roofmg material being installed. If a roof is 1. 1, 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 (Scc.7044, Business & Professions Code) z. 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: 6/7/2917 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. 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. 1 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 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, et ions 255023533, a 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: -- APPLICANT CERTIFICATION Date: 6/7/2017 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 Signature Date 6/7/2017 Professional CUPEWINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • bLj,"dr-g xou e tino.ora PROJECT ADDRESS /O r ' 1 l APN# OWNERNAME ,�( 6 AV T ve PHONE o� �, qq B,ol E AII /1"k STREET AD It SS V " CITY, STAT�ZIP c/ -r `� FAX CONTACT NAME Gerry Igtanloc PHONE650-759-18042 E-MAILgigtanloc@solarcity.com sTREETADDRESS391 Foster City Blvd. C", STATE, ZIP Foster City,CA,94404 FAX ❑ OWNER ❑ OWNERBUUMER ❑ OWNERAGENT 0 CONTRACTOR ❑CONTRACrORAGENT ❑ ARCHITECT ❑ ENGmm ❑ DEVELOPER ❑ TENANT CONTRACTORNAMESolarCity Corp. LICE Nu'OEP888104 FCENSETYPEc1oxm BUs.11C#28844 CGMPANYNAMESolarCity Corp. E-''""Lgigtanloc@solarcity.com FAX sT'E7ADDRESs3055 Clearview Way CITY, STATE, ZIP San Mateo, CA 94402 FKD'E650-759-8042 ARCHrrF= WGINEERNAME LICENSENUMBER BUS. LIC# COMPANY NAME E-MAIL f FAX STREET ADDRESS CITY. STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT IN HOOD ZONE ❑ Yes ❑ No ❑ SOLAR PANELS 1 ❑ ELECTRIC VEHICLE CHARGING STATION 1 ❑ SOLAR WATER HEATING ❑ OTHER FOR SOLAR PANELS NUMBER OF PANELS/UraTS: KnAWATTS (COMMERCIAL ONLY): TOTAL VALUAT I Q DESCRIPTION OF WORK Install rooftop mounted solar panels,(47S-2) KW l,U - ( YZ (� L4 L RECEIVED BY: n ne,(n C ,owner''ss By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property behalf. I hav read this application and the information 1 have sded 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 ding constructs orize{1(epresentatives of Cupertino to enter the above-iden ' ed for inspection purposes. Signature of Applicant/Agent -- ` °� •^ Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICEUSEONLY U ❑ OVW TM-CDDNTER ❑ IPRirss ❑ srANDARD ❑ LARGE ❑ MAJOR PV.4nn 7n77 dnc Pvisad /73/76/71 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0469 10159 S FOOTHILL BLVD CUPERTINO, CA 95014-2601(34214 117) SOLARCITY OWNER'S NAME: TANEJA VAIBHAV AND KOMAL OWNER'S PHONE: 408-448-0140 LICENSED CONTRACTOR'S DECLARATION License Class ROOFING Llc.#2BB1Q4 Contractor SOLARCITY CORPORATION Date 12/31/2018 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. I hereby affirm under penalty of perjury one of the following two declarations: r. 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. APPLICANT CERTIFICATION I 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulatio per the upertino Municipal Code, Section 9.18. Signature Date X28/2017 %l OWNER-tUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I 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 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' Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I shall 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 04/28/2017 CORPORATION SAN MATEO, CA 94402 DATE ISSUED: 03/23/2017 PHONE NO: (650) 963-5100 BUILDING PERMIT INFO: X BLDG X ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (N) 18 -PANEL ROOF TOP PV SYSTEM.(5.67 KW); NEW SUB -PANEL (125 AMP) REV#1 - DOWNSIZE TO (5.525 KW); (17) PANELS - ISSUED 4/28/2017 Sq. Ft Floor Area: I Valuation: $13000.00 "N Number: Occupancy Type: 342 14 117 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: MELISSA NAMES Date: 03/23/2017 RE -ROOFS: 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. Signature ofApplicant; Date: 04/28/2017 TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous 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 the Health & Safety Code, S ction 15505, 25533 . nd 25534. Owner or authorized agent:/1 Date: 04/28/2017 % CONST CTION GAGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILMMIDN 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 `. —' I (408) 777-3228 • FAX (408) 777-3333 • buiiding(d)cupertino.org CUPERTINO ❑ NEW CONSTRUCTION 1-1 ADDITTON I I AT TFT? ATTOW / TT �7TQTl1AT / nTMVDDt T -111-- ♦ i r BldgApp 2011.doc revised 06121111 PROJECT ADDRESS O ` t �OT I` li Ieuo vJ APN# OWNERNAME ( ` r� _ /�/ l7 PHONE c� v ( L( o E-MAIL STREET ADDRESSO ` ` �� CITY, S ATE, CT /�CLyXJC� 6TWO FAX CONTACT NAME —�i J—C�, � '�'° G�1 (�� PHONE (P SO •� -�C� �f�.. E-MAIL STREET ADDRESS � 2 S C fy L; �3oa` i CITY, STATE,ZIP S� s Q—A— 't Z FAX ❑ OWNER ❑ OWNER-BUILDEP ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME© LICET NATER r 6 LICENSE r BUS. LIC # l `Jl �lXl b COMPANY NAME / E-M,M,&M C ` FAX STREET ADDRESSSo \ ^nn\1 `� V P -(CITY �' �' L ST ���ZI � M91 ARCHITECT/ENGINEER NAME LICENSE NUMBER - BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK c) ` I EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEINGADDED? []NO ADDITION? []NO i PRE -APPLICATION []YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO - _ D TOTAL VALUATION: _ 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 ' corre t 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 buildin cons c o . I a thorize representatives of Cupertino to enter the above -identified propertyforinspection purposes. Signature Applicant/Agent: Date: )C-1, 2 1 of SUPPLEMENTAL INVORMATION REQr D PLAiv CHECK TYPE ROUTING SLIP ' ❑ OVER-THE-COUNTER ❑ BUILDINGPLANREVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS _ ❑ RI ANNINGPLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑: STANDARD ©: PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to p MAJOR ❑` SANITARYSEwERDISTRICt submittal of Building Permit application. ©. ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06121111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0469 10159 S FOOTHILL BLVD CUPERTINO, CA 95014-2601(342 14 117) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: TANEJA VAIBHAV AND KOMAL DATE ISSUED: 03/23/2017 OWNER'S PHONE: 408-448-0140 PHONE NO: (650) 963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C10. C46 Lic. #888104 Contractor SOLARCITY CORPORATION Date 12/31/2018 X BLDG X 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: (N) 18-PANEL ROOF TOP PV SYSTEM (5.67 KW); NEW SUB-PANEL I hereby affirm under penalty of perjury one of the following two declarations: (125 AMP) 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. 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: $13000.00 permit is issued. APPLICANT CERTIFICATION I 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 342 14117 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 regulations pe th Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALIX044NSPECTION. Signature-- Date 03/23/2017 Issued by: MELISSA OWNER-BUILDER CLARATION Date: 03/23/20 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 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 (Scc.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: 03/23/2017 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 maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. 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 Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, S tions 5505, 2 533, 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: 03/23/2017 \J I certify that I have read this application and state that the above information is CONSTRUCTION LENIL 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 Lender's 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 ARrHITECT'DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal a I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 03/23/2017 Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 A'E (408) 777-3228 • FAX (408) 777-3333 . buiiding@ctjoeltlno.org 15- ,1 C� L/ C� 1 PROJECT ADPRE I f V " • ®6 �C -6r' 7APN # — / 4V,/ OWNERNAME��9 i /1 ` PHONEYL/ EMAIL ,j ji STREETADDRESS G� �CITY, �'`�E �jOC9 ` A �� FAX CONTACT NAMEGerry Igtanloc -PH°NE650-759-8042 E-NIAMgigtanloc@solarcity.com STREETADDRESS391 Foster City Blvd. CITY, STATE, ZIP Foster Cily,CA,944041 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT 0 CONTRACTOR 11CONIRACTORAGENT ❑ ARCH cr ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRAGTORNAMESOIarCity Corp. LICENSENIJMBER888104 LICENSE MEC10,C46 BUS. LIC #28844 COMPANYNAMESolarCity Corp. E-MAIL gigtanloc@solarcity.com FAX STREETADDRESs3055 Clearview Way CITY STATE, ZIPSan Mateo, CA 94402 PHONE650-759-8042 ARCHITECTIENGINEER NAME LICENSE NUMBER e BUS. LIC # COMPANYNAME E-MAIL ¢ FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ NO PROJECT IN FLOOD ZONE ❑ Yes ,❑ No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER FOR SOLAR PANELS: NUMBER OF PANELSA MTS: j KILOWATTS (COMMERCIAL ONLY): 4 TOTAL VAI UAT(ON: a •� DESCRIPTION OF WORK Install rooftop mounted solar panels,( KW REC BY: 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 pro 'ded 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 b illi c ct on. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicandAgent: Date:f- SUPPLEMfTAL INFORMATION REQUIRED OFFICE USE ONLY,, �� ❑ OVER-TEW-COUNTER . D EXPRESS zz a a �` STANDARD ❑ LARGE ❑ MAJOR PYApp 2011.doc revised 03/16/11