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13120108CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10332 NOEL AVE , CONTRACTOR: ENERGYPROJECTSR:SUN WORK RENEWABLE PERMIT NO: 13120108 OWNER'S NAME: RANGANATHAN & ANANDHI RAMASWAM PO BOX 60250 1 DATE ISSUED: 12/13J2013 OWNER'S PHONE: 4084460104 1 PALO ALTO, CA 94306 1 PHONE NO: (650) 520-9918 LICENSED CONTRACTOR'S DECLARATION License Class C -6a Lic. d 9to 7312. Contractor.S''- WO& 901100— X61 Date 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: 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 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 regulations per the Cupertino Municipal Code, Section 9.18. /J��y Signature; G _ Date !?° A ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that l 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 (Sce.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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 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. I certify that in the performance of the work for which this permit is issued, l 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. Date BUILDING PERMIT INFO: BLDG F ELECT F_ PLUMB F MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: SOLAR PHOTO VOLTAIC SYSTEM, 6.0 KW 24 PANELS ROOF TOP MOUNTING Sq. Ft Floor Area: I Valuation: $19000 APN Number: 32647045.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR I80 D YS FROM LACALLED INSPECYION. %� Issued by: )Z-/3 '-� Date: 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: 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 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: '.� Date: Vs/slh CONSTRUCTION LENDING AGENCY 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 Add ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional W ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 . (408) 777-3228 • FAX (408) 777-3333 - buildlnq a7cuPerlino.Org PROJECTADDRESS p 0 � 3 2 A /a e,1 /1 ✓� W p L �V 1 /'t vim,/ APN N �% 2 �p d tf 5 OWNER NAME {JGn (M1+ Jr an RraSWA✓k PHONE CYo�� YY6 ' 0 0,f E-MAIL��ya�+� u�o0, teres, STREET ADDRESSCITY, ( o )'� 2 /U,)� vee, e— STATE, ZIP C w �,, ,,,o GQ j Sv / Y FAX CON ACT NAME BHy aP4 , �L Uo,k i r+e✓a6� t�ro`ecAs PHONE( E-MAIL PHONE E-MAIL t 6e,(i��wprba .D ST REET ADDRESS P o 5Cx, 6ozso CITY, STAT EAI (. A ( RY306 F 6sa iso- I3�1 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT �P CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME - sem. a, LICENSE NUMBER 90-7 3 2 - LICENSE TYPE BUS. LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex p Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ NO PROJECT IN FLOOD ZONE ❑ Yes ❑ No XSOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION �_[] SOLAR WATER HEATING ❑ OTHER: FOR SOLiRPANEI_S: NUMBER OF PANELS/UNITS: N KILOWATTS: TOTAL VA UATION. 0010 DESCRIPTION OF WORK p0 IGW � 9 / 1 pV e' !d`��1�,I7c. ��Ar' pro6P''I"� � S�-�✓"l I �i_d RECEIVED - By my signature below, I certify to each of the following: app] ication and the information I have provided is correct. ordinances and state laws relating to building construction. Signature of Applicant/Agent: (/vim I am the property owner or authorized agent to act on the property owner's behalf. I have read this I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local l authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Date:�Z�13/f3 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER G r F' U U :J a. ❑ EXPRESS ❑ STANDARD . ❑ LARGE' a.: MAJORi P VApp_2012. doc revised 06/20/12 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) ADDRESS: 10332 noel avenue DATE: 12/13/2013 REVIEWED BY: larrys :Lfec:h. Permit Fee: APN: BP#: /D�O�C/CJ *VALUATION: 1$19,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plumb. Insp. h7ee: PENTAMATION SOLAR -RES I PERMIT TYPE: WORK solar photo voltaic system, 6.0 KW 24 panels roof top mounting SCOPE NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) tbfech. Plan Check PItunb. Plcnn Cheek Dee. Ptan Cheek :Lfec:h. Permit Fee: Plumb. Permit Fee: Elec. Permit Fee: Other Afech. Insp. Other Plumb Insp.Li Ober Elec. Insp. 14ech. Insp. Fee. Plumb. Insp. h7ee: Elec. Insp. Fee: NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # $229.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruction Tax: Administrative Fee: Work Without Permit? Q Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 Travel Documentation bees: Strom? Motion Fee: 1BSEISMICR $1.90 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $1.001 SUBTOTALS: $2.90 $229.00 TOTAL FEE: 1 $231.90 Revised: 10/01/2013