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B-2017-1519 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1519 10727 LARRY WAY CUPERTINO,CA 95014-2056(316 02 006) SOLARCITY CORPORATION SAN MATEO,CA 94402 OWNER'S NAME: SATRAWADA CHANDRASHEKAR TRUSTEE&ET AL DATE ISSUED:09/11/2017 • OWNER'S PHONE: PHONE NO:(650)963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class ROOFING Lic.#888104 - Contractor SOLARCITY CORPORATION Date 12/31/2018 2(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)15 PANEL ROOF MOUNTED PV SYSTEM(4.875 KW);INSTALL I hereby affirm under penalty of perjury one of the following two declarations: SUB-PANEL-(200 AMP) •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. 1 =P have and will maintain Worker's Compensation Insurance,as provided for by 17 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$11000.00 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 31602 006 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 p- the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Sige `,� Date Issued by:Kim Dunbar �' Date:09/11/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am 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 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 to construct the project(Sec.7044,Business&Professions Code). Date: I hereby'affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will 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 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 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 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 air contaminants as defined by the Bay Area Air Quality Management District I' Worker's Compensation laws of California. If after making this 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 Co&- ecti is 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall IV / be deemed revoked. Owner or authorized -re tl�1 .! ' L" APPLICANT CERTIFICATION Date: `.. I certify that I have read this application and state that the above information is, •CONSTRUCTION LEND i CAGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit 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 againstliabilities, 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. I understand my plans shall be used as public records. • Licensed Signature Date Professional. • _- �' ALTERNATIVE ENERGY PERMIT APPLICATION Lo / COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISIONAE 1 �5 `''ss 10300 TORRE'AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildinga@.cupertino.orq 6 -2-01i--/67 9' PROJECT ADDRESS/6414 j 0 . box-,../`j APN#3/ice _ D7 0 0 co OWNER82.46 v1.4 so 7 11.4_10 1.4 04_4/+ C.c t PHONELc .13073 /�l�l Acji•tA ® cleadel SQA.eat 9O i cy FAX CONTACT NAME Gerry Igtanloc PHONE 650-759-8042 E-MAIL gigtanloc@tesla.com STREET ADDRESS 391 Foster City Blvd. CITY,STATE, ZIP Foster City FAX ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT I CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME SolarCity Corp. LICENSE NUMBER 888104 LICENSE TYPE C1O,C46,BBUS.LIC# COMPANY NAME SolarCity Corp. E-MAIL gigtanloc@tesla.com FAX STREET ADDRESS 3055 Clearview Way CITY,STATE,ZIP San Mateo, CA 94402 PHONE 650-759-8042 ARCHITECT/ENGINEER NAME LICENSE NUMBER e71007- COMPANY NAME E-MAIL FAX -V7 i/® CJJ(( /1 /JA STREET ADDRESS CITY,STATE,ZIP PHONE USE OF 13 SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial, INTERFACE AREA 0 Yes 12 No FLOOD ZONE ❑ Yes �] No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING 0 OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATION: l( / 60 6 DESCRIPTION OF WORK Install( (c) roof mounted solar panels. (1t }� )KW. f , 0 —7 RECD,#.I BY: 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 provided 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. ing construction. I authorize representatives of Cupertino to enter the above-identified property or inspection purposes. Signature of Applicant/Agent: Date: C>i( 0 Sr(( SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE.ONLY . >.❑ OVERTHE-COUNTER ' ',❑ EXPRESS ' '• .❑ STANDARD d 0 LARGE :f s ❑ MAJOR PVApp 2011.doc revised 03/16/11 DocuSign Envelope ID:822E9574-7476-4FE1-9874-B2CD1252C8E6 L • ❑ DD • l SMOKE/ CARBON MONOXIDE ALARMS - .. OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228 FAX(408)777-3333•buiidinqOcupertino.orq Permit No. Address 10727 Larry Way Cupertino, CA 95014 P;ifAlarms 2 .;b:10:4.4 , 2 ; .. � • . .;;::;.;PE1RN�_IT;_C�AN�IQT:BEFINALED_�l�CO1VII,'xE�'EDUNTILT1rIIS.CERTIFICA'1'E .:. fAS Elft Tv i x_O Til to B i. i +iGDLVI .Oi _ vi j„j^ PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for .compliance with 2013 CRC Section R314,2013 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 $1006:00,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 the X 1 X bedroonn(s) On every level of a dwelling unit including basements X X ;: Within each sleeping room X ,i Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and;that da not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBCSection 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. hi:existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations'do ndt 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 have been tested and are operational, as of the date signed below. _ !have read and agree to comply with the terms end conditions of this statement Owner(or Owner Agent's)Name: DocuSigned by:, Chandra Satrawada - r t,aan,I,Va SgrefWa�.a. �, 9/19/2017 ...... ......... .. Contractor Name: C2C6BF6B�656468... k Signature LIc.# Date: ..:................ Smoke and COform.doc revised 03/18714 DocuSign Envelope ID:822E9574-7476-4FE1-9874-B2CD1252C8E6 \\ / WATER-CONSERVING PLUMBING FIXTURES t' OWNER CERTIFICATE OF COMPLIANCE Y,=rr I COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building a�7.cunertino.org Owner Name Chandra Satrawada Permit No. Address 10727 Larry Way, Cupertino, CA 95014, US (SANTA CLARA.County) . .'PIRMiT.CANNOT BE TNALED AND COMPLETED UNTIL'THIS CE•RTIFICATE •.••.: • HAS``B EN�S:YCI hA D ET:., . D:..0 ........":.. .. _..G: IVIS �•.:, :.: ::E�,;::. ...::..:.:.........:::...;::.:::.........:..iIRI�E>t?TTHE�3:U�D�?- �M��4N.. ;:.: Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. - 1. Is your real property a registered historical site? © Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. DocuSigned by: Owner'Signature: (.44,„,,h„, Sra,,/a�(,a„ Date: 9/19/2017 ® No Go to Question 2. C2C6BF6B1656468... 2. Does your real property have a licensed plumber certifying that due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? ❑ Yes . Civil Code Sections 1101.1 through 1101.8 do notapply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. DocuSigned by: Owner'Signature: CCAIA..a,yiq, SA-Irawadq, Date: 9/19/2017 i 'No Go to Question 3. C2C6BF6B1656468... 3. Is water service permanently disconnected for your building? p yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. DocuSigned by: Owner'Signature: DA I,I,A. S 'alA/° . Date: 9/19/2017 i�No Go to Question 4. C2C6BF6B1656468... 4. Is your real property built and available for use or occupancy on or before January 1, 1994? • 0 No , My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. ,—DocuSigned by: atA1Owner'Signature: " ° �a VaWa Date: 9/19/2017. `—C2C6BF6B1656468... IE Yes My real property is built and.available for use or occupancy on or before January 1,1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. ►! My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January I, 2017, all non-compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures(regardless of whether property undergoes alterations or improvements). C] My property is a nnnitifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with'water-conserving plumbing fixtures. On or before January 1,2019,all noncompliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). El My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with'water-conserving plumbingfixtures. SB407 2014.doc revised 03/18/14