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B-2017-1074CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1074 18965 TILSON AVE CUPERTINO, CA 95014-3657 (375 10 06 1) �SUNRUN OWNER'S NAME: BLACK WILLIAM AND ANDERSON LEI OWNER'S PHONE: 408-839-5633 License Class GENERAL BUILDING CONTRACTOR Lic. #Z50184 Contractor SUNRUN INSTALLATION SERVICES INC Date 06/30/2018 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. I 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 erfom3ance of the work for which this permit is issued. YI 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 unprrtino Municipal Code, Section 9.18. Signature Date 07-06-2017 OWNER -BUILARATION I hereby affirm that I m 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 (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 07-06-2017 INSTALLATION SERVICES INC SAN LUIS OBISPO, CA 93401 DATE ISSUED: 07/06/2017 PHONE NO: (415) 580-6900 BUILDING PERMIT INFO: BLDG X ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (I) 24 -ROOF MOUNTED PV SYSTEM (6.9 KW); (N) SUB -PANEL (100 AMP) LOCATED TO REAR Sq. Ft Floor Area: I Valuation: $14076.00 APN Number: Occupancy Type: 375 10 061 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 07/06/2017 RF–ROOFS- All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 07-06-2017 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. 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 theCupertino nicipal Code, Chapter 9.12 and the Health & Safety Code, ctio 5505, 25533, and 25534. Owner or authorized agent: Date: 07-06-2017 CO STRUCTIOWNDING 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed ALTERNATIVE ENERGY PERMIT APPLICATION jj COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTlN0 - (408) 777-3228 • FAX (408) 777-3333 • buildingIi1gjpetnc,org �� PROJECT ADDRESS 18965 Tilson Avenue I APNA 37510061 OWNERNAME William Black PHONE (408) 893-5633 E�MAM will.black@gmail.com STtSETADDRES518965 Tilson Avenue crrY. STATE. ZIP Cupertino, CA 95014 FAX COYf.ACr NAIVE Vance Jason I PHONE (408) 506-3693 I r-MA'L vance.jason@sunrunhome.com TKEE; ADDRESS Same as Contractor I CITY, STATE, ZIP FAX j ❑ OWNER d ONNLR.IlU -DER. Cl 0'-t":-3 AG= ^. CONLRACTOR ❑ C4117RACTOR AGMENT ❑ ARCF3T'C ❑ ENan�-=ER ❑ DEV„LAPER E. !. h: r CONTRACTOR NAME Sunrun LICENSE NUMBER 750184 i LICENSETY?E C-46 "L's.Llcrr 27932 COMPANYNA14B Sunrun E.MML ` FAX (408) 894-9294 STREET AnoaEssCI 575 Dado Street zP E. San Jose, CA 95131 PHONE (408) 747-2487 ARCHITECTIENOTNEER NAME LICE: SE NUNISER HUS. LIC e COMPANY NAME E-MAIL FAX 57REET ADDRESS CITY, STATE, ZIP P14ONS USE of 9 SFD or Duplex ❑ Multi-FEmily PROJECT IN W[LDLAND PROJECT IN STRUCTURE: ❑ commercial URBAN RJTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ No SOLAR PANELS ❑ ELECTRIC VEFULI£ CHARGING STATION ❑ SOLAR WATER BEATING ❑ OTHER FOR MIAR PAIVUS+ T 14HER OF PANELSJUn9TS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATTOS' $14, 076.00 DEscRIPTtoNaFWORK 6.9KW PV (24) MODULE SOLAR ROOFTOP INSTALLATION NEW 100AMP SUB -PANEL TO BE INSTALLED. - .yF J 0 -t By my signature below, I certify to each of the following: 1 am oPerry owner or authorized agent to act on thi property owner's behalf. I have read this application and the information I have provid is orrec r d the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building ruc - auth a re atives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent Date: 07/06/2017 SUPPLEVENTAL 11MATION REQUIRED 13 PVApp 1011.doc revised 03/16/11 CUPERTINO 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 • building(a�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 ALARM 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 6very 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 R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical ermit is required for alanns 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. / Address: I $-1 �5 f I L'S n " 015 Permit; No. " - pt -7 -1071- Specify Number of Alarms: # Smoke Alarms: I T I # Carbon Monoxide Detectors: �1 I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: W< lA .�..............Date:..... Signature ................................................................................... ..5.....�....... ContractorName: wl0 V V1 1.....U......: .....:....... Date:A.n.... Signature..................Lic.# .... Smoke and CO, b,rm.doc revised 0111012017