B-2017-1391CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1391
11882 SHASTA SPRING CT CUPERTINO, CA 95014-5107 (366 55 023) SUNRUN
INSTALLATION
SERVICES INC
SAN LUIS OBISPO, CA
93401
I OWNER'S NAME: BUDARA.TU SIVAKUMAR AND HEMA I I DATE ISSUED: 08/21/2017
OWNER'S PHONE: 408-338-6084 1 I PHONE NO: (415) 580-6900
LICENSED CONTRACTOR'S DECLARATION
License Class C-46 Lic. # 0 8
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
400ierformance of the work for which this permit is issued.
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.
APPL.ICA_NT 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 applican understands and will comply with all non -point
source regulatio s per Cupertino Municipal Code, Section 9.18.
lure Date 8/21/2017
OWNE -BUILDER L ION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
2. 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:
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
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
LaborCode, I must forthwith comply with such provisions or this permit shall
be deemedrrevoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to oo'mply 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 mention ed. property for inspection purposes. (We) agree
to save indemnify arid) 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 8/21/2017
PERMIT INFO:
BLDG X ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
(1) 15 PANEL ROOF MOUNTED PV SYSTEM (3.9 KW); (N) 125 AMP
SUB PANEL
Sq. Ft Floor Area: I Valuation: $7956.00
"N Number: Occupancy Type:
366 55 023
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby A, eende
Date: 08/21/2017
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: 8/21/2017
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 the Cupertino icipal Code, Chapter 9.12 and
the Health & Safety Code, Se tions , 25533, and 25534.
Q�er or authorized agent:
Date: 8/21/2017
CONSTRUCTION
I hereby affirm that there is a construe n 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
COMMUNITY DEVELOPMENT DEPARTMENT-• BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPEl2TI NO (40a3) 777-3228 • FAX (408) 777-3333 • building0cupertino,orq
B_zon-_)z)qj
r�'
PROMa ADDRESS 11882 Shasta Spring Court
AF" 366-55-023
1
oumaENAMr
Sivakumar Budaraju.
PHONE 408 338-6084
I ( )
E-MAIL @g mail.com
sivakumar.budarNu@gmail.com
STREETADDRESS 11882 Shasta Spring Court
Com' STATE, 211, Cupertino, CA 95014 FAN
coh'7ACT Rkms Vance Jason
I PHONE (408) 506-3693
�'t' R vance.jason@sunrunhome.com
STREET ADDRESS Same as Contractor
CITY. STATE, ZIP
FAX
i] &Mot ❑ 014M -BUILDER ❑ 004--tAWT aL 00Kr ACTOR ❑ COh7PACT0AAGFW M /It mr.cT ❑ WtQGQ-m% 12 ow -s APER ❑ TENAINT
CON`nUCTORNAME
Sunrun
PCENSENWIBER UMWSETYP' •
750184 C-46
BUS LiC 7
27932
COMPAW NAME Sunrun
EWAIL
PAx (408) 894-9294
STRi?EFAn[]RFSS 575 Dado Street
CITY, ST' ZZIP San Jose, CA 95131
Fxa (408) 747-2487
ARCMTRCT1L?aGNEF,RNAME
LICE2rSENITUM ER
BUS. lit B.
COMPANY NAME
FrMAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PP,ONS
USE o: lg� SFD or Duplex ❑ Multi-Fzm ly
STRUCt FS- ❑ Culnuaercial
PA0iECTINFWILDLAN1)
URBAN INTERFACEAREA ❑ Yes ❑ No
vnojEEcrTN
FLOOD OD{E Yes 0 NO
N SOLAR PANELS ❑ ELECTRIC VEmcmri CItAIwwo srATioN
❑ SOLAPLAWATER W- CING
® ,OTHEP'i
FOR SOIAR PANELS: NUMBER OFPAN-LSNNITS_
KILOWAM(COMMERCEALONLY):
TarALUAtLFATIO %; $7,956.00
13E=WTI0N.0FW0M, 3.9K -W PV (12) MODULE SOLAR ROOFTOP FLUSH MOUNT INSTALLATION
NEW 125AMP SUB -PANEL
TO BE INSTALLED
LST , _t
a
K�
By -my signature blow I certify w each of the following
application and the infaimation I have pro id is co et.
ordinances and state lad's relating to buil n - c 111 cti I[
Signature of ApplicandAgent;
a property owner or authorized a?ent to act un the, property, oit*s 6M f. i hav reed this
8V read the Description of W.ark and verify it is accurate. I agree to comply %*h'all applicable local
-a ' e n pies ritat ' s tifCuperlino to enter the At vc-identificd property has in5pectio-11 purposes.
Data; 08/21/2017
SuPPL4N LNT'A •ORMATION REQU=-D
c k.
G+�C"1 T.r � ar
fa" `0Jf t2B_ ESS a
N1.1-16-1
�y��iw
i
4zra•3c.Y�`Xzw`
P KApp_201 Ldgc revisad 03116111
DocuSign Envelope ID•CC31BEA5-C706-4586-9E29-1A01B0282640
,`. SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
ru G°�r COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CIJPERTlNt7 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinqAcuoertino.orq
PERMIT- 0.T_BE`EINALED,T1I�TM I :THIS.CERTIFICATE_HAS,BEEN
CO,VIPLETED,Sf GNID, 4ND RETURNED TO'THE BUILDING DIVISION
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
$1000.00,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 in 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-burningappliances 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)maybe 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 907.2.114 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
Address: 1 S. Z 5 R-A-5 t/ $ ig4 �7 - Permit No. .8-20(7--13 7/
Specify Number of Alarms: #Smoke Alarms: 16 #Carbon Monoxide Detectors: $2
I have read and agree to coma with the terms and conditions of this statement
Owner(or Owner Agent's)Name: °'
�`�A' U % Signature . ••44•0••w i�« .. 9/9/2017 .Date:
-Contractor Name: g �
u1J 4v N
Signature_ ., ��,.r,.. Lic.# Date: t
Smoke and COform.doc revised 12/15/16