B-2017-0626CITY OF CUPERTINO BUILDING PERMIT i
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0626
19710 DRAKE DR CUPERTINO, CA 95014-2434 (316 32 020)
SUNRUN
INSTALLATION
SERVICES INC
1
SAN LUIS OBISPO, CA
93401
OWNER'S NAME: NAGARAJAN SUBRAMANIAN AND ANURADHA
DATE ISSUED: 04/20/2017
OWNER'S PHONE: 408-506-3693
PHONE NO: (415) 586-6900
I
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C46 Lie. #750184
Contractor SUNRUN INSTALLATION SERVICES INCDate 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
�
(1) 14 -PANEL ROOF MOUNTED PV SYSTEM (4.0 KVO
I hereby affirm under penalty of perjury one of the following two declarations:
1. 1 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. 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
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permit is issued.
Sq. Ft Floor Area:
Valuation: $8610.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type: i
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
316 32 020
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.'
Signature Date 4/20/2017
Issued by: Abby A, eY nde
Date: 04/20/2017 i
I hereby affirm that 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. 1, as owner of the propert3; 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.
i
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant: j
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 4/20/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 1 have and will maintain a Certificate of Consent to self -insure for Worker's
- - -
j
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
z. 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. 1 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 If
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino M ipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 0 , 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: 4/20/2017
I certify that I have read this application and state that the above information is
I to laws
1 hereby affirm that there is a constru i ending agency for the performance(
correct. agree comply with all city and county ordinances and state
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,
1
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
HITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 4/20/2017
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUELDING DIVFSIDN
10-300 TORRE ANENUE - CUPERTINO, CA 95014-325,5 AE
1405) 777-322B - FAX �408) 777=3233 * tAdinq4-auDerth-Q, org
PRG.166 AMIMMS 19710 Drake Drive
APN N 316-32-020
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0AWm1wea *
Subramanian Nagarajan
(408) 499-9474 paravasam@gmaii.com
STREBTADDRESS 19710 Drake Drive
Cay, STATZ 21? Cupertino, CA 95014 FAX
1!06STTA"-r XA-MF- Vance Jason
MONE (408)506-
Mvance.jason@sunrunhome.com
5TREEMADWRESS
Same as Contractor
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COMACTORNAME
Sunrun
UCERSENW.BER
750184 C-46
27932
CGMPA)NXAM9
Sunrun
PN
]-T"x (408) 894-9294
STUrk ADDRESS 575 Dado Street
CITY, STA-�-- ZIP San Jose, CA 95131
(408) 747-2487
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WORMNT—ION REQUIRI-0
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