Loading...
15030107CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20204 MERRITT DR CONTRACTOR: BAY AREA SOLAR PERMIT NO: 15030107 SOLUTIONS OWNER'S NAME: STEVE TAKAKI & FRANCES LEE 6700 SANTA RITA RD #E DATE ISSUED: 03/17/2015 OWNER'S PHONE: 4088889558 PLEASANTON, CA 94588 PHONE NO: (510) 293-0366 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL C] �[ LICENSED CONTRACTOR'S DECLARATION / ` INSTALL 15 PV MODULES, ROOF TOP -FLUSH MOUNTED 2 �}� Qom% 2 Lic. # - l(/0(,P (3.9KW) License Class V �� Date f17/45- Contractor 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: 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 Valuation: $11700 rformance of the work for which this permit is issued. Sq. Ft Floor Area: ave and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31633098.00 Occupancy Type: ection 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAY PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter the above mentioned property for inspection purposes. (We) agree to save 180 DAY AST CALLED INSPECTION. upon indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Iss Date: , 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. RE -ROOFS: e 5 All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) property, rty, am exclusively contracting with licensed contractors to I, as owner of the roe y g HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous as defined by the Bay Area Air Quality Management District I Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25533. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: permit is issued. 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO I�IIJJI FFF ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, Fire, sanitary Sewer visirici, ocnooi T� 1. , d ., .i- availahlo and are nnly an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E f 7%1`13) ADDRESS: 20204 MERRITT DR DATE: 03/17/2015 REVIEWED BY: MELISSA APN: 316 33 098 BP#: S��C) "VALUATION: 1$11,700 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p t'hemh. Insp. F, - PENTAMATION SOLAR -RES PERMIT TYPE: WORK I INSTALL 15 PV MODULES ROOF TOP -FLUSH MOUNTED 3.9kW SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, Fire, sanitary Sewer visirici, ocnooi T� 1. , d ., .i- availahlo and are nnly an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E f 7%1`13) FEE 1'hwmb. Plan Check Elea. P/an Check Nwnh. Pcrmit Clec, Permit Pee: Other Mech. Insp. Other Phamh Insp, Vier F.,lec, Insp. Mech. Insp. Fee: t'hemh. Insp. F, - acc. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, Fire, sanitary Sewer visirici, ocnooi T� 1. , d ., .i- availahlo and are nnly an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E f 7%1`13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $236.00 Alternative Energy System 1PHOTOVRES Photovoltaic System Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.7onstr action :Tax: Administrative Fee: E) Work Without Permit? © Yes (j) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential or Structure (F) Travel Dociunentution Fees:Building Strong Motion Fee: 1BSEISMICR $1.52 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2.52 $236.00 TOTAL FEE: $238.52 Revised: 02/14/2015