B-2017-0574CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0574
21879 RUCKER DR CUPERTINO, CA 95014-4759 (356 15 011) SOLARCITY
CORPORATION
SAN MATEO, CA 94402
OWNER'S NAME: LEE IRENE TRUSTEE & ET AL
OWNER'S PHONE: 650-539-8770
LICENSED CONTRACTOR'S DECLARATION
License Class C-10: C-46 Lic. #888104
Contractor SOLARCITY CORPORATION Date 12131/2018
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.
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.
)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 regulatiWs pey1he Cupertino Municipal Code, Section 9.18.
.��•�atur
� Date
6, Cu r.,
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 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)
2. 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:
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.
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.
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 4112/2917
-aa
ISSUED: 04/12/2017
PHONE NO: (650) 963-5100
BUILDING PERMIT INFO:
X BLDG X ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
INSTALL BATTERY BACK UP AND LOAD CENTER SUBPANEL (125
AMPS)
Sq. Ft Floor Area: I Valuation: $5000.00
"N Number: Occupancy Type:
356150
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Ayende
Date: 04/12/2017
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: 4/12/2017
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS ATERIALS 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 ectio 255 25533, and 25534.
Owner or authorized agent:
Date: 4/92/2017
CONS N LE 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 DECLAR TION
I understand my plans shall be used as public records.
Licensed �.
Professional
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 M'
CUPERTINO
❑ PLUMBING ❑ MECHANICAL �I ELECTRICAL n MISCELLANEOUS
(408) 777-3228 •FAX (408) 777-3333 • building(a)cupertino.orq
PROJECT ADDRESS , I , io ^
APN #
OWNER NAME & ►tib C, � tSLL...
PG�Q • 5 3 -1 ° �q �
E-MAIL
STREET ADDRESS^ / "� C%4 �-+
CITY, STATE 'N C I
(//
FAX
CONTACT NAME Gerry Igtanloc
PHONE 650-758-8042
E-MAIL gigtanloc@solarcity.com
STREET ADDRESS 3055 Clearview Way
CITY, STATE, ZIP San Mateo, CA 94402
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHFIECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME SolarCltyCorp.
LICENSE NUMBER 888104
LICENSE TYPE
C10, C46, B
BUS. LIC # 28844
COMPANYNAME SolarCity Corp.
E-MAIL gigtanloc@sloarcity.com
FAX
STREET ADDRESS 3055 Clearview Way
CITY, STATE, ZIP San Mateo, CA 94402
PHONE 650-759-8042
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ® SFD., DUPLEX ❑ MULTI -FAMILY
BUILDING, ❑ COMMERCIAL
PROJECT IN WEALAND ❑ YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN ❑ YES
FLOOD ZONE ❑ NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ONO
DESCRIPTION OF WORK ®n� V T`� L
S� pc ,
TOTAL VALUATION:
RECEIVED -BY: WAWA - -
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property own is behalf I have read this
application and the information I have provided is rrect. 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 co struc on.' uthorize repr atives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPL MENTAL INFO
TION REQUIRED
OFFICE USE ONLY
HE -COUNTER ..
"
.Q STANDARD "-
.
LARGE..
CD -MAJOR"
MEPMiscApp 2011.doc revised 06/21/11
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 • buiiding(@cupertino.org
PURPOSE
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
SMOKE ALARM
CO ALAR_ M
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
X
Within each sleeping 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 alarm(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 specified below have been tested and are operational, as of the
date signed below. A
Address:
C.�
Permit Noi.2017 0,57'&
Specify Number of Alarms: ! t!Smoke Alarms: # Carbon Monoxide Detectors: ����!
with the terms and conditions of this statement
Smoke and CO for•m.doc revised 01/10%017
17
WATER -CONSERVING PLUMBING FIXTURES
- OWNER CERTIFICATE OF COMPLIANCE
IQ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPERTIN€? 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)1777-3228 • FAX (408) 777-3333 - building(c)cupertino.org
Owner Name e- Le / Permit No p �iV6 `f
Address �-�UW Iia C/ �4 C
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.
VNo Go to Question 2.�z,0
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 fonn. %
'/No Go to Question 3.(,
3. Is water service permanently disconnected for your building? {
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
VNo Go to Question 4.
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.
III Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1191.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form.. _�L-L E-11 /Zi"
5. PI se check ONE of the following:
FMy 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).
❑ 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-conseiving 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-conseiving plumbing fixtures comply with the requirements as indicated in the
table on the followingage.
Owner or Owner Agent's Signatur Date:
Upon completing and signing this C:ertiticate, please return it io me-ounamg LiviNiuii In Ul Ui W uiiai y.,u, V---5 r� __
SB407 2015. doc revised 01/05117
GROUND SPECS
MAIN PANEL SPECS
GENERAL NOTES
LICENSE
Panel Number: HDM30UC
CA # 888104
Meter Number: 1006675139
C-10
E 125A MAIN SERVICE PANEL
N 10OA/2P MAIN CIRCUIT BREAKER AUTOMATIC (N) 125A
(E) WIRING RELAY no Load Center
(N)100A/2P UNINTERRUPTIBLE
ZPOWER SUPPLY
Y 30A/2P
(E) Loaos oo L1 X
' Lz
N
30A/2P Ecc
G
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I
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— EGCIGEC
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TO 12D/24DV
SINGLE PHASE
UTILITY SERVICE
TO (E) LOADS
I
i
Voc't = MAX VOC AppT MIN TEMP
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POI (1)A tE B esker �30A/2P, 2 Spaces X (1)TAC PDWERWALL 5 BkVA; Home Energy Storogs,13.0011 — Rev C AC
(Z1 )Tesla p 1116431—OD—B Y (1)BRYANT # BR91BL125RP
Z
BACK-UP GATEWAY; for ACPW2.0, ASY, NA with 3G, Rev B Load Center; 120/24OV, NEMA 3R
—(1 )TMeterr 1112484-00-A[[125A,
it12Nsy WD CURRENT XFMR, ENERGY GATEWAY for ACPW2.D, 2 CT's —(1) BreokerH 30A/2P. If 2 Spacces Battery Breaker
xith
ITT 1 AWG q10, THIN 2, Block IITT (1 )AWG /10, THWN-2, Block
)AWG p10, THWN-2, Red O 13f— (1 )AWG /10, THWN-2, Red
_
LOLL (1 )AWG #10, THWN-2, White NEUTRAL LL-LL (1 )AWG /10, THWN-2, White NEUTRAL
_(I) AWG p8, THWN-2, Green EGC—(1)Conduil Kit; 1-1/4' EMT—(1)AWG /10, THWN-2, Green EGC—(1)Conduit Kit; 3/4" EMT
CONFIDENTIAL — THE INFORMATION HEREIN Boa
CONTAINED SHALL NOT BE USED FOR THE
BENEFIT OF ANYONE INC.,
NUMBER : JB-9508595 00
PREMISE OWNER: DESCRIPTION:
ERIC r�TOM LEE EM- Eric Tom LEE RESIDENCE
21 H7.7 RUCKS
SICK: �—
Tail
SolarCity.
MOUNTING SYSTEM:
CLCEPT IN WHOLE
NOR SHALL IT BE DISCLOSED IN WHOLE OR IN
Unable To Calculate Mounting Hardware
® -f ding pa merh KW P� ARRAY
PART TO OTHERS OUTSIDE THE RECIPIENTS
ORGANIZATION, EXCEPT IN CONNECTION WITH
CUPERTINO, C
MODULES:
(0)
3055 Cle—i . way
THE SALE AND USE OF THE RESPECTIVE
SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN
PERMISSION OF SOLARCITY INC. INVERTER
:
r Et` EWE � 1 C, ] CNAPL ,�r_M NAME:
SHEET: REV: DATE:
Son Noteo, CA 944D2
- THREE LINE DIAGRAM
SC 1 4/5/2017
(668)—SOLO)gTTYY (766.9-2489)5--olorcitycom
T
POWERWALL 2 AC BACKUP
Tesla Powerwall is a fully -integrated AC battery system for residential or light
commercial use. Its rechargeable lithium -ion battery pack provides energy storage
for solar self -consumption, load shifting and backup power.
Powerwall's electrical interface provides a simple connection to any home or building.
Its revolutionary compact design achieves market -leading energy density and is easy
to install, enabling owners to quickly realize the benefits of reliable, clean power.
PERFORMANCE SPECIFICATIONS
AC Voltage (Noirninall) 208 V, 220 V, 230 V, 2'7'7 V,
100/200 V, 120/240 V
IFeed lin "llype Single & Split. -Il
Girild Firequency 50 and 60 Hz
MECHANICAL SPECIFICATIONS
Dimensions 1150 nirn x 755 nirn x 155 nirn
(45.3 in x 29.7 in x 6.1 in)
Weight 125 kg (276 lbs)
mountiling Options Floor or wall mount
100%
50 V
89.0%
10 years
Val I) oPr I �Irovldmf for ("' (ff 1") 2. 2 k"'N I �onor
'ValuoP it glon dopoindord
'A,(',' to hallory to AG' al hoglininling of lifo
COMPLIANCE INFORMATION
Safety Ul 1642, Ul 1741, Ul 1973,
Ul 9540, U N 38.3, IEC 6210"-'1,
IEC 62619, CSA 022.2.107.1
Girild Standards Worldwide Compatibility
ll:::'irnissions FCC Part 15 Class B, ICES 003,
EN 61000 Class B
ll:.ancllosuire "llype
NEMA 31IR
Ingiress Ratiling
111167 (Battery & Power Electronics)
111156 (Wiring Corn part men t)
IMoilse ILeuell @ 1 irn
<40 dBA at 30'C (86°F}
ENERGY GATEWAY SPECIFICATIONS
Dimensions
691 nirn x 378 nirn x 129 nirn
(27.2 i n x 14.9 i n x 5.'1 i n)
Weight
16.4 kg (36 lbs)
Disconnect Current 200 A
Ingiress Ratiling NEMA 31IR
Oveircunrent Piratection IBirealkeir 100 200 A
(01ptionall)
Useir IInteirfface Tesla App
Connectivity Wi.-Fi, Ethernet, 3G
ll:..�nvilironirnen tall IlRoHS Directive 2011/65/EU, AC IMeteir IFdeverrue grade
WEEE Directive 2012/19/EU,
2006/66/EC Operating IModes Support for self.-consurription,
Seilsirnilc AC156, IEEII::.� 649-2QQ5 61;igh) backup, off -grid, export limits
C U ) 9 � U." Autornatic disconnect for
searriless backup transition
l 9122m
amVirtein't
0 Supports up to 10 AC. -coupled
Powerwalls
REWME.l.) FOR CODE CONA[I[JANCE
Reviewed By: Abby Ayande p 1:::: I l
Date: 04117117
TYPICAL SYSTEM LAYOUTS
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SOLAR
ENERGY
GATEWAY
GRID
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SOLARINVERTER
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SUB PANEL +
MAIN PANEL
CRITICAL HOME
LOADS LOADS
C U 1) E 1I1 11140
POWERWALL 111,13 u PII II d PII iiP"i g I) e p a r,t im e in't
REWME'D FOR CODE CONA['[JANCE
Rev�ewed ByAL)L)y Ayande
Data: NMI 7117