B-2017-1460 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1460
13326 STEVENS CANYON RD CUPERTINO,CA 95014-542(351 21 009) RHINO POWER INC
SAN JOSE,CA 95125
OWNER'S NAME: SANTA CLARA COUNTY DATE ISSUED:09/01/2017
OWNER'S PHONE:408-529-1921 PHONE NO:(408)287-7117
_ ►__ I s. VI: I '_. .. BUILDING PERMIT INFO:
License'Class C-10 Lic.#843416
Contractor.RHINO POWER INC Date 10/31/2018 X.BLDG,x ELECT _PLUMB - ,
MECH RESIDENTIAL X 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: •
REPLACE EXISTING 200 AMP PANEL WITH SAME SIZE
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
60.2...../ 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
permit is issued. Sq.Ft Floor Area: Valuation:$2300.00
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 35121 009
representatives of this city to enter upon the above mentioned property for
inspection purposes. gree to save indemnify and keep harmless the
City of Cupertino again Mia ilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrrgagli t in consequence of the granting of this permit.
i� ^ ' WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally;th=applicant gun 8r,�ands and_will comply with all non-point
source,regul.. . s per the pertin. Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date ,®9 / Issued by:Phuong Devries
1 / Date:09/01/2017
0 A:- :UILD R t CL _O_�
I hereby, • the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofmg material being installed.If a roof is
i.j I,as owner of the property,;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)
2.; I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors io construct the project(Sec.7044,Business&Professions Code). Date:
i I
I hereby,affirm under penalty of perjury,one of the following three declarations: „ „
1.1'. I have and will maintain a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS A OR BETTER
Compensation,as provided foriby Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
2.,. I have and will maintaiti*orker,'s Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor,Code,'for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
a. 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 - material.Additionally,should I use • s Ai ent or devices which emit hazardous
shall not employ an erson m any manner so as to become subject to the Area Air Quality Management District I
p y y p air contaminants as defined �• .�e
Worker's Com ensationlaws of California. If,after making this certificate of will maintain compliance •fth t; ��. cip'al Code,Chapter 9.12 and
exemption,I become subject to,the Worker's Compensation provisions of the the Health&Safe ode,Se i 5533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
• be deemed revoked. Owner or auth razed agent: ,
APPLICANT CERTIFICATION Date: /� / .
I certify that I have read this application:and state that the above information is ! j / - I` I ' - s` - - `til A LC
correct.I agree to comply with all'city and county ordinances and state laws I hereby a m that there is a construction lendin gency for the performance
relating to building construction/and.hereby authorize representatives of this city of work's for which this permit is is 1.,-= 97,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-pointisource regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. ! r' I understand my plans shall be used as public records.
i
Signature � Date Licensed
Professional
CONSTRUCTION PERMIT APPLICATION
\^�/ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
y-C.Iy,
w f s (408) 777-3228 • building@cupertino.org PEMIT#B- 20 f - 1140
CUPERTINO REV# DEF#
❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. D MEF ❑RE-ROOF [I SWIMMING POOL/SPA
PROJECT ADDRESSAPN#
13326 Stevens Canyon Road I 35 I 2( 00
OWNER NAME PHONE E-MAIL
Cal Fire c/o Fire Captain Gene Parks 408.529.1921 gene.parks@fire.ca.gov]
STREET ADDRESS CITY,STATE,ZIP
13326 Stevens Canyon Road Cupertino,CA 95014
❑x CONTRACIUR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
Fred Menbari RHINO Power, Inc. 843416 C-10
STREET ADDRESS CITY,STATE,ZIP
1980 Stone Avenue San.Jose,CA 95125
E-MAIL " - PHONE IBUS.LIC It
fred@rhinopowerinc.com 408.287.7117 403479
0 ARCHITECT ❑OWNER 0 OWNER AGENT I CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER❑TENANT
_ CONTACT NAME E-MAIL
Fred Menbari fred@rhinopowerinc.com
STREET ADDRESS CITY,STATE,ZIP PHONE
1980 Stone,Avenue San Jose,CA 95125 408.287.7117
DECRIPTON , .
Replace existing 200A meter main with new like 200A meter main
❑SINGLE FAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I'TOTAL NET SF USE TYPE OCC SQ.FP. VALUATION($)
REMODEL REMODEL KTTCHEN REMODEL OMR GARAGE 0 ATTACHED
BATHROOM SF SF SF SF 0 DETACHED
EXISING ❑YES EICHLER, ❑YES ' SECOND STORY ADDITION ❑YES
FIRE SPRINKLERS 0 NO 1 ; 0 NO 0 NO
DWELLING SECOND DWELLING DYES I0 ATTACHED❑DETACHED OTHER
UNITS ffi IUNIT ADDTTON: 0 NO SF
POOLS 0 FIBERGLASS '❑VINYL-LINED 0 GUNITE 0 PREFABRICATED
POOL-SF SPA-SF I ' I 'SPA ATTACHED❑YES 0 NO I TOTAL-SF
RECEIVED )l'
Commercial or Multi-Family Buildings With Public Swimming Pools requires Department of Environmental Heath approval 'I1Ai,
\t TOT/ V�A6UATIO
1 J �L/ •JL b �d
-
RE-ROOF EXISTING ROOF TYPE:!0 BUILT-UP ROOF 0 ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGL OTHER(SPECIFY)
PLYWOOD ❑� ❑3/8" PLYWOOD TYPE: PITCH:
REMOVE/REPLACE NO IF NO " ROOF CLASS
DYES OF I AYERS THICKNESS❑5/8" OTHER ❑OSB 0 CDX OTHER .12 A
PROPOSED ROOF TYPE:❑BUILT-UP'ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER
*Provide a signed copy of the Cupertino's Tear-Off Policy SF not SQUARES
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 informatit11ave •rovided is correct. I have read the Description of Work and verify itis accurate. I agree
to comply with all applicalile;local grdinance and stat- ,ws-relati`ng to building construction. I authorize representatives of Cupertino to
enter the. above-identified property(or' •ecti . •. .oses. I acknowledge and authorize all information contained on this application form
to be made available foripublicrecord-
Signature of Applicant/Agent:,, Date:8/31/17
SUPPLEMENTAL INFORMATION REQ (i•ED
*New SFD/Second DwellingIUnits/Mulhfamil' Swellings:A Dem. Hon permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: Provide'acomp'leted Hazar: : :a als Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Ietter;or Meeting with Planning prior to submittal of Building Permit application.
*HOA-Provide a letter of approval from the Home Owner's Association
BldgApp 2017.doc revised 08/01/17