B-2017-1758 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1758
10166 BARBARA LN CUPERTINO,CA 95014-2902(359 12 024) BAY AREA SOLAR
SOLUTIONS INC •
PLEASANTON,CA
94588
OWNER'S NAME: ZHENG CHANGXUN AND XU JIN TRUSTEE DATE ISSUED: 10/12/2017
OWNER'S PHONE:408-858-3265 PHONE NO:(925)380-9500
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C10 Lic.#928652
Contractor BAY AREA SOLAR SOLUTIONS INC Date 02/28/2019 X BLDG _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)8-PANEL ROOF MOUNTED PV SYSTEM(2.64 KW)
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
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:$7600.00
, 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 359 12 024
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 perthe Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatur-°` , &d:261 / Date 10-12-2017 Issued by:Kim Dunbar
�% Date: 10/12/2017
OWNE -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: 10-12-2017
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,3 become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 2 534.
Labor Code;;I must forthwith comply with such provisions or this permit shall y /,
be deemed revoked. Owner or authorized ag
APPLICANT CERTIFICATION Date:10-12-2017
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
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 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. I understand my plans shall be used as public records.
Licensed
Signature Date 10-12-2017
Professional
\ Jf ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIONA E
�sT.,9ss 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinqRcupertino.orq
PRGJECTADDRESS- .10166 BARBARA LANE APNS 359-120-24
OWNER.NAME CHARLES ZHENG PHONE 408-858-3265 E-MAIL czaddr@gmaiIcorn„
STREET ADDRESS 10166 BARBARA LANE CITY,STATE,ZIP FAX
CCIPERTINO,CA 95014 • - T -
CONTACT NAME John Woolwa PHONE 9253809500 E-MAIL
y John.woolway@yourenergysolutions.com
'STREET ADDRESS CITY,STATE,ZIP FAX
6700 Santa Rita Rd Pleasanton Ca 94588
ID'0 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTACTOR ,IN/CONTRACTOR AGENT 0 ARCHITECT ❑ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUk,61 3 2
Lou Zaughbaba. 928652 C10f1
COMPANY NAME .Your Energy Solutions E-MAIL FAX
, Lou@yourenergysolutions.com .
STREET ADDRESS, CITY;STATE,ZIP PHONE
6700 Santa Rita Rd Pleasanton Ca 94588 9253809500 , '
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC S _
COMPANY NAME E-MAIL .FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF M SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND PROTECT IN
STRUCTURE: 0 Commercial URBAN INTERFACE AREA 0 Yes r4"No FLOOD ZONE 0 Yes r"No
VSOLAR PANELS _ 0 ELECTRIC VEHICLE CHARGING.STATION 0 SOLAR WATER HEATING 0 OTHER: .
FOR SOLAR PANELS: NUMBER OFPANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): T VALUATIOfou
7 '0
DESCRIPTION OF WORK
Installing 8 Panels with a system size of 2.64
ntt
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the p .pe owners 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 ding constru
ction. I authorizerepresentativess.
of Cupertino to enter the above-identified property for inspection purpose
/
Signature of Applicant/Agent: _4;:- WB9/ / Date: 10/12/17
S ''LEMENTAL INFO• •0 ON REQUIRED ,,oFPICE USE'oi r
*W,r:: ❑r OVER THE-COUNTER$a '
❑�EXPYtESS� �d�'�� �����N
❑,STANDARb
gr 0 LARGE
PYApp_2011.doc revised 03/16/11
�a"" t:, =RGYS L UTIONS
The Smarter Solar Company!
Building Department
To whom, it may concern:
I hereby authorize John Woolway to act as my agent to sign and file the
documents necessary to obtain a permit for the installation of a PV solar electric
system.
I declare under penalty of perjury that I am the Licensed Contractor for the
project in the city listed above and I certify the above information is true and
accurate.
egards,
Lou Zughbaba
Licensed Contractor
Lic#928652
Your Energy Solutions
(888)888-0711
6700 Santa Rita Rd., Suite E www.YourEnergySolutions.com
Pleasanton, CA 94588
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
Ef
�r.rssf COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION -=--
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildino(a)cupertino.orq
PERMIT CANNOT BE:I<'INALED UNTIL:THIS CERTIFICATE:JR AS BEEN
COMPLETED,SIGNED,AND RETURNED TO THE BU LDING DIVISION
PURPOSE
This affidavit is a sell-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 X X
bedroom(s)—(Smoke alarms shall not be located within 3 feet of bathroom door)
On every 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 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: I 0 (67 lgAl7LYA P l'- ( " ' 6 r �T Permit No.t--capi 1-n5(6
Specify Number of Alarms #Smoke Alarms. MAI #Carbon Monoxide Detectors:
l have read and agree to comply with the terms and conditions of this statement
Owner� (or Owner Agent's)?Name:
Ch nyCi4�l `E'}"t em9 Signature �(/" 1
Date: f
Contractor Name:
Signature Lic.# Date: .
Smoke and CO form.doc revised 01/10/2017