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B-2017-1392CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1392 21686 NOONAN CT CUPERTINO, CA 95014-5912 (357 19 073) ALL ON ELECTRIC INC LIVERMORE, CA 94550 OWNER'S NAME: PANELL PAUL C AND JAN C TRUSTEE DATE ISSUED: 08/21/2017 OWNER'S PHONE: 925-599-6466 PHONE NO: (925) 447-0581 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic. #9A4_973 Contractor ALL ON ELECTRIC INC Date 04/30/2019 X BLDG X ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: (N) 19 -PANEL ROOF MOUNTED PV SYSTEM (6.27 KW); (I) PANEL I hereby affirm under penalty of perjury one of the following two declarations: (125 AMP) 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 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 e Sq. Ft Floor Area: Valuation: $25000.00 permit is issued. APPLICANT CERTIFICATION ION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 357 19 073 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municip Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatur Date 08-21-2017 Issued by: Kim Dunbar Date: 08/21/2017 I hereby affirm ¢hat; Iam 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. I,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. sale'(Sec:7044, Business &'Professions Code) z. I asl owner of the'property, 'am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 08-21-2017 I hereby affirm'under,„penalty of perjury one of the following three declarations: . 'a 1. I have and will maintain a Certificate of Consent to self-insure for Worker's „ „ ALL ROOF COVERINGS TO BE CLASS A OR BETTER Comp, nation, 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. I have! andwill 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 LaboijCode, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit' is issued. I' maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I 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 I 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 WI Compensation laws of California. If, this air contaminants as defined by the Bay Area Air Quality Management District I orker's after making certificate of will maintain compliance with the.Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, nd 25534. Labor Code, I must forthwith comply with such provisions or this permit shall F� . be deemed revoked. I Owner or authorized agent: % APPLICANT CERTIFICATION Date: 08-21-2017 I certify that I have read this application and state that the above information is CONSTATIVWLENDINGENC correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is Pconsfruction lending agency for the performance WQ relating to'building construction, and hereby authorize representatives of this city of work's for which this 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, 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 ARCHITECT'S DECLARATION Code, Section 9:18. 1 understand my plans shall be used as public records. Signature Date 08-21-2017 Licensed Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin-ga-cupertino.org / TZ . PROJECT ADDRESS n' b () C± APN# 3-5— 7 -)17o ` � OWNERNAME % r/J PHON Z� Y/La E-MAIL STREET ADDRESS G 1 / �. 4 0 ©l0� I �j /� CTI'Y, STi TEv,/ZI , " © L� / FAX CONTACT NAME Gl HOVN P z � S �'f� � 3 &MAIL J-1 C? t' STREET ADDRESS CYR CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR XO RACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME q� I l / C /Y LICENSE NUMBER LI?,N,5 TYPO r C' jCJ 9O Sri 1 COMPANY NAME E-MAIL FAX STREET ADDRESS/ L'.� L' �'r �, U� CITY, STATE, ZIP LI`✓ems 1�r 9�1S-J'J P H Z41q, �-o3 ✓tO� orc- c ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF -KSFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD, ZONE ❑ Yes ❑ No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): 1 11 TOTAL VALUATION: DESCRIPTION OF WORK /` 5.0 Cev- ' e Jv FIVI'e- l- n 4 . r e,- J -o l DO I/a 4-1 42 By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's, behalf. I have read this application and the information I have.prod ed 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 relating to bu' o ction Ize representatives of Cupertino to enter the above- identified propertyforinspection purposes. 2 Signature of Applicant/Agent: Date: PL MENTAL INFORMATION REQUIRED ��"RY�IE THEQC�OTil+l`I'ER b� ,�F1a�� y�x{�jpW� �d� �kt�,U�A `lz qhs $,'4r'ARCyE��"�'�'ISI'y y r" �R2 5 gM1' 1WA Pu '+i 'r.3Ts`"rtx 04 rr#JORI�,rytj.z�'.ss.„'aa�'`h. PVApp_201 Ldoc revised 03/16/11 v-, /.:, SMOKE / CARBON MONOXIDE ALARMS .f,;, OWNER CERTIFICATE OF COMPLIANCE 4;9 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255. (408)777-3228• FAX(408)777-3333. buildings cupertino.orq z i u4( .. ¢': E'' ' # r'S� rte, �2 P,A'4 -4,4 $ .mo . , . ,5 x A x tea* £ k , z -. �'tt .u"'�X �rz a� s ERMIT CANNOT EFINALEI TIL THIS CERTIFICATEFHAS BEET CD�LETE €I NED,� g RETU D TOTIFB INN DI��IO 1 7 -2,,,,,,,,,„„„_ _ ._- . . - err -,— k m� '"'''''A''''77 '''' �� � _..�.'�+d'OTti PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314,2016 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 $1.000.00, CRC Section R314 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•irrn the immediate vicinity of X X the bedroom(s) On every level of a dwelling unit including basements 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 permit is required for alarms 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/.,, �,/� �/�,� 0„,,,,,,,, Address:� CQ li V, �'U a �LG�G Q /I Permit No. Specify Number of Alarms: #Smoke Alarms: 1 ( #Carbon Monoxide Detectors: I , I /have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: -N5-q Signature. \ .... 40 . ... . 0-9_✓7 Date: Contractor Na e: Signature Lic.# Date: 1 Smoke and CO form.doc revised 12/15/16