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13100013CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20222 RODRIGUES AVE CONTRACTOR: SOLARCITY PERMIT NO: 13100013 OWNER'S NAME: STEPHEN LEUNG 3055 CLEARVIEW WAY DATE ISSUED: 10/01/2013 OWNER'S PHONE: 4088929884 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL I License Class Lic. INSTALL 14 ROOF -TOP FLUSH MOUNTED SOLAR / PANELS Contractor Date (3.5 KW) I hereby affirm that I am license 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 Sq. Ft Floor Area: Valuation: $14000 performance of the work for which this permit is issued. 1 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: 36932052.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agreecomply with all city and county ordinances and state laws relating WITIUN 180 DAYS OF IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROWLA5T LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, _ "`- costs, and expenses which may accrue against said City in consequence of the, W 0 J-..3 granting of this permit. Additionally, the applicant understands and will comply Issued Date: with all non -point source regulations per the Cupertino Municipal Code, Section" - 9.I8. _.._._� `` '"' a - 3 mm ' RE -ROOFS: Signal, e -w~ - Date 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. ❑ OWNER -BUILDER DECLARATION Signature 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 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) 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(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should 1 use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this "- "—r�. Owner or authorize,�t�a -'"� Dater 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 µ" Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name 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 Date ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNIT',DEVELCRVIENT DEPARTNIE"F - BUILDING --l1f "S I CN j3OO CUPERTINO, CA �5C'4 TORR AVENUE a_320^ CUPERTINO 4r�S' 777-3-228 - F:AX A081 -77-��,333 PRCJrC- A.DDREESSI .1 NqL ';"' 3 6 - I- - DJ ZZ J P Tj, (I I T MAIL AD C77y. 3-1 %T-- AX S.?XET DRESSppr k a,56'0 C.^.`�-rA--T NA -ME F-VAZ. M, EEET ADDRESS T7Y.S-rA7I!. ZIP FAX )vv-4ER J 0w-,Vt-BUILDFA OWNVE JIGEW4L-1 T RACTOR 7J CONTILAC7")k ALOE -,7 kkCHrrF('-, FNIGN -tM !)CVEL,-,PF.A TED, k�t-. CONI'MkCrIM NAME -�e L/ A16N -'I' CONP AN Y 14A.14E AA 6 —2 12 v ' ""N 0� ba� L611 XTIUM- ilDD�ES' k U" I" S 6 `34A2. S-�MET ADDRESS C".. 7:p pHeNT USE OF 5FD or Duplex 7 Nlulti-family ;-.-,'AUDI-1.-:D IN Y--3 Nf 0 E Y�s MUCTIALF Commercial SOLAR P&NELS e FLeC-.-R:CVPhICLEr]LARGrNGS-,ATIGIN 0 i0LARWATSK;'EATTNG crr,-E?, Ff) R SOLAR PAVELS NUMBER I;r PANELS)LNr1­3 TZ,y' w; DESCRn"2W0F'ArOKK V L/ 1CP1iCZD1C ;c-sl ha- pTov;ded is cored. ave. ad:hc 10:�]L' !1 apoil,ation and .he anforvauon!v ordi.-jances and bu,11din"g-on , .,'o' -n— Wh.017;7E C-C)r if este: 11I.L: i Vc, ji'enrir-cd pmprrtv 'or mspectlen p:)rpoScs Signature ofApplic—it/Age.-i t -Z. ST:PPLE\tKAE-T'T RE T 'I RE D OFTICE USE ONLY EXPRESS STAIMARD MAJOR ?K4 ll - pp_z jfij .:Mc -- CITY OF CUPERTINO I FEE ESTIMATOR - BUILDING DIVISION 10 ADDRESS: 20222 RODRIGUES AVE DATE: 10/01/2013 APN: 369 32 052 BP#: / J ��L��� REVIEWED BY: MELISSA *VALUATION: 1$14,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plan Check Fee: PENTAMATION SOLAR -RES PERMIT TYPE: WORK INSTALL 14 ROOF -TOP FLUSH MOUNTED SOLAR PANELS 3.5 kW SCOPE NOTE. This estimate does not include fees due to other Departments (ke. Planning, Public Works, Fire, Sanitary Sewer District, School Dictriet ote ) Thoco fooc aro hacod nn tho nroliminary infnrmalinn availahlo and nro nnly nn octimalo_ Cnntart tho Dont for addn'l info_ FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $229.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 1 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced PlanningFee: $0.00 Select a Non -Residential Building or Structure 0 0 i %r,� �f �;�r,rzrayr�rrical�otr /�1s_ Strong; Motion Fee: IBSEISMICR $1.40 Select an Administrative Item Bldg, Stds Commission Fee: 1BCBSC $1.00 $2.40 $229.00 $231.40 Revised: 08/01/2013 CUPERT'INO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: v'P—„ S A PERMIT # k 3 L 0 00 � OWNER'S NAME: 2�av\ PHONE # 6 GENERAL CONTRACTOR: BUSINESS LICENSE # �C ADDRESS: CITY/ZIPCODE: QK a`f *Our municipal code requires all businesses Working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND --ALL-- C AVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE r'-",'- -. ""° I am not using any subcontract Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting ' Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masom y Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date .. C2 I;ig- W Q .14 G r nom o w n: Y FH F-- S O ti OccO .i.l S. 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