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B-2017-1951 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1951 10822 WILLOWBROOK WAY CUPERTINO,CA 95014-4541(369 22 045) CLEAN SOLAR INC • SAN JOSE,CA 95112 OWNER'S NAME: GAN WEE-CHEN AND SIM CHING-FEN TRUSTEE DATE ISSUED: 11/14/2017 OWNER'S PHONE:408-896-8266 PHONE NO:(408)217-8876 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic.#910849 Contractor CLEAN SOLAR INC Date 02/28/2018 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) 10-PANEL ROOF MOUNTED PV SYSTEM(3.2 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 1 Compensation,as provided for by Section 3700 of the Labor Code,for the • ,� performance of the work for which this permit is issued. Ibo o. 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:$12250.00 ' APPLICANT CERTIFICATION • I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 369 22 045 representatives of this city to enter upon the above mentioned property for inspection purposes.I(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments • ts,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequenc- t . anting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applil understands an. ill c. pl with all non-point source regulations p- -'Cupertino Mu,icipal 'od-,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signat In*.„___ Lam. Date 11-14-2017 Issued by:Kim Dunbar lipI , Date: 11/14/2017 0 A ►_ --I. I. I_ _ .L:___I► RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons All roofs shall be inspected prior to any roofing material being installed.If a roof is i.; I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for i inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,$usiness &Professions Code) 2. 1,as owner of th'e property,an exclusively contracting with licensed Signature of Applicant: ;contractors to construct the project(Sec.7044,Business&Professions Code). Date: 11-14-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER i' , ;l 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' 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 haza us material. Additionally,should I use equipment or devices which • hazer ous ' shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay • •a Air Quality Ma .gem nt Distri t I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cu.erti o Muni'pal Co'e,C•+pter 9.1 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,.ecf'ns 2550 _ -d 25534. Labor Code,I must forthwith comply with such provisions or this permit shall /j be deemed revoked. Owner or authorized agent. L APPLICANT CERTIFICATION Date:11-14-2017 _ I certify that I have read this application and state that the above information is '' 04 ►i ► : EN" correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that ther .*struction 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 shbll be used as public records. Licensed Signature Date 11-14-2017 Professional \\1 / ALTERNATIVE ENERGY PERMIT APPLICATION (1.0 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIONAE 01-t9,4., 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinci cupertino.orq CUPERTINO �0l q- -195- I •PROJECT ADDRESS/0 /cs„?..„.;_, 1// J(j ) APN# •� _ I /)/�1/-� OWNER NAME 6a_ /06i2 p /e ,H NE /��Top,"4„d - `/` E-MAIL ),A ) e �+/`_„, / S2 fir/ ✓. ,7 d� STREET ADDRESS //1 ed 2 //1�/ J„ J L.4 -., ., � IIP Iv / FAX l�' ��CONTACT NAME/ /� �� `, / 0 1 "-c/� / ' E MAu J )syn�re n/an ;4/,edx- STREET ADDRESS /qt"/ �� /1/J Cry `. %CI_TY T ZIP/ /� £a1 -' A 76-7/2_ o OWNER 0 0 R-BUILDER 0 OWNER AGENT ONTRACTOR : 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER' 0 DEVELOPER 0 TENANT CONTRACTO NAM J r ,��/a� LIC 4R yl!• lox LICENSE TYP6.16 BILS. 1) COMPANY NAME J v' E L U FAX (/ m eGJ / Ji .,cd ) STREET ADD# !✓ / w/( ac, k.., j/ ) (C Z ,s7/ 400e6--,1,-)t/6,- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMP AME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA. 0 Yes FLOOD ZONE 0 Yes VO SOLAR PANELS .❑' ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER: 4 ^^^�� ] FOR SOLAR PANELS: NUMBER OF PANELS : KILOWATTS(COMMERCIAL ONLY): TOTALJdALIIIATIOIG 3 DESCRIPTION OF WORK !// / i A 6/ .a,e'eg/'''1' "it- ("/0 PIttp.a/-)Ws 7v^. — CCO /a. Cs, 7/4. .J . - 0.--- , ED. By my signature below,I certify to each of the 'olio ing: I am the ro.-. owner or authorized gent to act on the property owner's behalf. I have read this application and the information I have provid..is•.rrect. I have re..the De ription of Work d verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bQ•• true . . .. iorize representatives of Cup no to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: S '`• '91,NTAL INFORMATION ' P G IRED ";, -- OFFICE USE ONLY.' - 'alf ,/ i - W ❑ OVER-THE-COUNTER • l 1• 1 ❑"EXPRESS , 11=1:1 STANDARD LARGE, , ❑' MAJOR PVApp_2011.doc revised 03/16/11 SMOKE / CARBON MONOXIDE ALARMS FILE fit OWNER CERTIFICATE OF COMPLIANCE 11^3�1O-- e,% COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 GUPERTU4O (408)777-3228•FAX(408)777-3333•buildinq(a�cupertino.oro PERMIT CANNOT BE FIINALED UNTIL:IH.IS CERTIFICATE.HAS BEEN COMPLETED,SIGNED,AND-RETURNED TO THE DIILDINO.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,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 907.2.114 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 alami(s) referenced above has/have been installed m 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 date signed below Address 100'21 U`J) f 1rOO1C-- UJ(.( Permit No. 2-0( / 1 cf Specify Number of Alarms #Smoke Alarms I t #Carbon Monoxide Detectors 1 I have read and agree to comply wit , e terms and conditions of this statement Owner(or Owner Agent's)Name: ,/ p U•••)tiSCL-."i` \. Signature.. ...... ... . . .Date: 4 .3 Contractor Name: (� �� / (1. 41-7 y C i ett,!'1 5a(1 Signature !' y..: lily. Lic.# SLI e `I )1 d � .(! Date: .. . Smoke and COform.doc revised 01/10/2017