13120179CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10300 PALO VISTA RD
CONTRACTOR: CLEAN SOLAR
PERMIT NO: 13120179
OWNER'S NAME: GREG & AMY EVERETT
1445 KOLL CIR STE 109
DATE ISSUED: 01/02/2014
OWNER'S PHONE: 4082422611
SAN JOSE, CA 95112
PHONE NO: (408) 217-8876
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
LICENSED CONTRACTOR'S DECLARATION
AINSTALL
18 ROOF TOP FLUSH MOUNTED PV PANELS
License Class 011W94q Lic�# CIO
(4.5KW)
Contractor_uun_-J Mv Dat,_fj?� 114
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
Valuation: $20312
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
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
APN Number- 35702055.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
IS
PERMIT EXPIRES IF WORK NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
for inspection (We) agree to save
180 DAYS FROi CALLED INSPECT ON.
upon the above mentioned property purposes.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Date:
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,
4
_R&ROOFS.
being installed. If a roof is
Signatur W. Datejj?�[
All roofs shall be inspected prior to any roofing material
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
0 OWNER -BUILDER DECLARATIONSignature
of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, 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)
1, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
as defined by the Bay Area Air Quality Management District I
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25 11 5, 25533, and 255 4.
(414A A
Section 3700 of the Labor Code, for the performance of the work for which thisOwner
or authorized ager Datej�:l
permit is issued.
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
CONSTRUCTION _LENDING AGENCY
compensation laws of California. if, after making this certificate of exemption, I
I
I hereby affirm that there is a construction lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor Code, must
work's for which this permit is issued (Sec. 3097, Civ C.)
forthwith comply with such provisions or this permit shall be deemed revoked.
Lender's Nam
APPLICANT CERTIFICATION
Lender's Address
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
ARCHITECT'S -DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records,
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional�
9.18.
Signature----
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - buildingaculpertino.org
PROJECT ADDRESS C0
500 valo VIM god
APN 9 -7 --
I -'4
OWNER I
PHONE 409 2-4 2- 2�j t E-MAIL
STREET ADDRESS 0 3c),() V
CITY, STAT ,ZIP j, �, 0 C q
p
FAX
CONTACT NAME
PHONE4
N '�Do fl C)�
E-MAIL
k ��
�
STREET ADDRESS I aK 1611
CITY, STATE, ZIP (_M n j N e LA 6[S[11ZX
n OWNER ❑ OWNER -BUILDER OWNER AGENT *IONTRACTOR CONTRACTOR AGENT 171 ARCHITECT 1:1 ENGINEER 13 DEVELOPER ❑ TENANT
CONTRACTOR NAME �' �0- rl-i-tch
LICENSE NUMBER C1
I
LIfSFTYPE
, c4b
BUS, LIC:!
COMPANY NAME C (C'a (so Wr
E-MAIL
FAX
STREET ADDRESSPHONE
(� K -L Dr
CA
5 S� 56-1-7(o2
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS, LIC 9
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF 0 SFDorDuplex 0 Multi -Family
STRUCTURE: 0 Commercial
PROJECT' IN WILDLAND PROJECT
URBAN INTERFACE AREA 0 Yes 0 No FLOOD
IN
ZONE 0 Yes C3 No
OLAR PANELS
11 ELECTRIC VEHICLE CHARGING STATION � 11 SOLAR WATER HEATING
❑ OTHER:---
FOR,VOLAR PAIVEGY: NUMBER OF PANELSIUNITS: 16 0 KILOWATTS: 4.5
TOTAL VALUATION*
Gil
DESCRIPTION OF WORK ln(falll IS PVpantl� roof moviatc4 Tluc--k
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property fb��a�ehalf. I have read this
application and the information 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 relati g to uildin constr4ction. I autho ize representatives of Cupertino to enter the above- identified property for inspection purposes.
Signature of Applicant/Agent Date: 12- 1-2-o 3
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
OVER-TTIE-COUNTER
EXPRESS
STANDARD,
aLARGE
Q.
MAJOR
P VApp.2012. doc revised 06120112
H
CITY OF CUPERTINO
[3 f-11
FEE
REVIEWED BY: MEL18SA
MISC ITEMS
Plan: Check Fee.,
$0.00
11 1X41110 till WX
PRIMARY
SFb or buolex.
USE.
OWN,,
r, m1i
INSTALL 18 ROOF TOP FLUSH MOUNTED PV PANELS_(4.5kW
$0.001
-We'ck Plan Check phemb, Plan Checi, L"Iec. plarl Che'll,
MechPern-lit Fee: Phtmb, pe mi! Fee,- Dee, Permir Fee:
riSP� Othcr Plumb Imp, Other fi,'Iecc, InVI
Alech. Insli, Fee: Phaeb. Etec. Insp. Fee"
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
based on the prolimi"a i"farmatian available ana are only an esumare f-onract ane —P, ur UUU" I Ift/c
FEE ITEMS 6Fee Resolution 11-053 Eff 711113)
FEE
QTY/FEE
MISC ITEMS
Plan: Check Fee.,
$0.00
1 #
$
Alternative Energy System
TOVRES Photovoltaic System
Suppl. PC Fee: C), Reg. 0 OT��s
$0.001
PME Plan Check:
$0.00
�Permit Fee:
$0.00
suppl. Insp. Fee -.19 keg. 0 OTT
_0_�_
.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
F-1
Adininis'trative.Fee:
Work Without Permit? 0 Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
Travel
Strong Motion Fee: IBSEISA11CR
$2.03
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
S
PURTOTALS;
$3.03
$229.00
'PT
$232 .031
Revised: 10/0112013
Project Description
#4
1) Modules: (18) Canadian Solar CS6P-250M modules to GEC connected
(E) water pipe GE rod
2) Microinverters; (18) Enphase M215-60-2LL-52x
3) Monitoring system with Microinverters
4) Standard components include; racking and
mounting components, wiring, conduit, and overcur-
rent protection, roofing sealant or flashing, as needed
5) No battery back-up systems
6) Main electrical panel, inverter and controller panels
will be labeled with warning labels
7) All Metal parts of module frames, equipment and
conductor enclosures will be grounded
8) All outdoor wiring will be weather rated APPLY THIS LABEL TO ALL
JUNCTION BOXES:
LABELS
Labels will be Weather Resistant, Red
with White Lettering
MAIN SERVICE PANEL
1. AC Solar Input Breaker. Do not relocate this
breaker.
2. WARNING - Dual Power Sources.
Second source is photovoltaic system
3. WARNING - Electric Shock Hazard DO NOT
TOUCH. TERMINALS on both Line and Load
sides may be energized in the Open Position.
4. CAUTION - Solar PV system installed. When
power disconnect, solar panels and wiring in
conduit may remain energized.
5. Max AC Operating Current: 9.90 A
Operating Voltage: 240 V
JUNCTION BOXES
1. WARNING - Electric Shock Hazard.
No user serviceable parts inside.
Contact authorized servicer for assistance.
2. CAUTION - Solar PV wiring may remain
energized after disconnection during daylight
hours.
RACEWAY
1. CAUTION - Solar Circuit
2. Apply this label to Conduit every 10 feet:
'PHOTOVOLTAIC POWER SOURCE'
Property line
"CAUTION: SOLAR PV
WIRING MAY REMAIN
ENERGIZED AFTER
DISCONNECTION
DURING DAYLIGHT HOURS"
(N) Array: (11) Canadian Solar
CS6P1A$gM !"les
?l
Front
(N) Electrical runs over roof,
penetrates eave, then runs to
(E) MSP on external wall
Property line
Property line
Property line
NO TH
(N) Array: (2) Canadian Solar
CS6P-250M modules
1st story
Notes
1) This drawing is diagrammatic in some respell. -i�.e—lci-,ier�exac�conditions prior to beginning work
2) Electrical run is approximate and will be determined in the figid by our electrical installers —
3) Some roof details omitted for drawing clarity
4) System built per 2010 California Electrical Code 690
5) Conduit runs over roof (N) Array: (5) Canadian Solar
6) No setback & No AC disconnect required for the City of Cupertino CS6P-250M modules
N
0
0
0
1st sooty 1st story
MAIN SERVICE PANEL LABEL:
"CAUTION: SOLAR PV SYSTEM
/I INSTALLED. WHEN POWER
DISCONNECT,
1st story SOLAR PANELS AND WIRING IN
/ I
CONDUIT MAY REMAIN ENERGIZED."
A711T)Lltn:�A` .i' i'
Roof_s1o_pe:_210______
L
PROJECT VALUATION
Composite Shingle roof
Total Value of Project: $20,312
lbs Mounts
SYSTEM SIZE RATING
90.0
STC rated: 4.500 kW
31.78 lbs/Loading Points
CEC-AC System Rating: 3.940 kW
lbs Miaoinverters
LEGEND
Ist story
MSP Main Service Panel
Canadian Solar CS6P-250M
& utility meter
lbs Total Weight
Junction BOX
311.9
Fnphase Nficroinvertars
64.5"x 38.7"x 1.57"
mountiro are-, -
max ,t -greet .apart
lbs/sq ft
—Conduit Run
vent
Module Area: 17.33 sq it
GE Grounding Electrode
Back ft
,10
M
STRUCTURAL CALCULATIONS
Weight System Totals Point Loading
754.2
lbs Modules
953.4 lbs Total Array
30.0
lbs Mounts
30 Loading Points
90.0
lbs Packs
31.78 lbs/Loading Points
79.2
lbs Miaoinverters
Canadian Solar CS6P-250M
953.4
lbs Total Weight
Module Dimensions:
311.9
sq If Array
64.5"x 38.7"x 1.57"
3.06
lbs/sq ft
Module Weight: 41.9 Itis
Module Area: 17.33 sq it
CLEAN
SOLAR INC.
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Cont. Lit # 910849
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