B-2018-0027CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0027
7542 SHADOWHILL LN CUPERTINO, CA 95014-5052 (362 30 09 1) SOLARCITY
CORPORATION
SAN MATEO, CA 94402
OWNER'S NAME: TAI PHILIP HUI-YUH AND TIFFANY YUN-HSIEN TR I I DATE ISSUED: 01/09/2018 1
OWNER'S PHONE: 408483-8992 1 1 PHONE NO: (650) 963-5100
LICENSED CONTRACTOR'S DECLARATION
License Class B. C10, C46 Lic. #888104
Contractor SOLARCITY CORPORATION Date 12/31/2018
I hereby affirm that 1 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:
1. 1 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.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
n A I Section 3700 of the Labor Code, for the performance of the work for which this
�J permit is issued.
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
and state taws 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 indemnify and keep harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against said City in consequence of the granting of this permit.
Additionally, the app' ant understands and will comply with all non -point
source regul i s e the Cupertino Municipal Code, Section 9.18.
Signature Date 1/09/2018
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1, 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)
I, as owner of the property, am exclusively contracting with licensed
contractors to constrict the project(Sec.7044, Business & Professions Code).
BUILDING PERMIT INFO:
X BLDG _ ELECT _ PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
(N) 15 PANEL ROOF MOUNTED PV SYSTEM (4.5 KW)
Sq. Ft Floor Area: I Valuation: $6660.00
APN Number: Occupancy Type:
362 30 091
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Jasmine Archbold
Date: 01/09/2018
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, 1 agree to remove all new materials for
inspection.
Signature of Applicant:
Date: 1/09/2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR
1. 1 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.
2. 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.
3. 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 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 trust forthwith comply with such provisions or this permit shall
be deemed revoked.
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 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 indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
consequence of the 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.
la�i- Iltk7f'Zti[1
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should 1 use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Co Secti 25505, 25533, and 25534.
Owner or authorized agent:
Date: 1/09/2018
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO CA 95014-3255
(408) 777-3228 • building@cupertino.org PEMIT qB - - 7
CUPERTINO I REV # DEP#
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION ❑ T.I. ❑ MEP ❑ RE -ROOF ❑ SWIMMING POOL/SPA
PROJECT ADDRESS APN #
7542 Shadowhill Ln Cupertino, CA 95014 v Q
OWNERNAME PHONEE-MAIL
Greg Breshears 408
483-8992
STREETADDRESS
CITY, STATE, ZIP
7542 Shadowhill Ln
Cupertino, CA 95014
JWJ CONTRACTOR NAME []OWNER -BUILDER
NYNAME
LICENSE NUMBER LICENSE
TYPE
Christina Vierra (Agent)
7SolarCityDBA Tesla
888104 B,C10,C46
STREET ADDRESS
CITY, STATE, ZIP
391 Foster City Blvd
Foster City, CA 94404
E-MAIL
PHONE
BUS. LIC N
cvierra@tesla.com
650-865-0112
888104
DARCHITECT ❑OWNER OOWNERAGENT D CONTRACTORAGENTO ENGINEER El DEVELOPER O TENANT
CONTACT NAME
E-MAIL
SAME AS CONTRACTOR
STREET ADDRESS
CITY, STATE, ZIP PHONE
DECRIPTON
Install roof mounted solar 4.51<W, 15 Panels
IHISINGLE-FAMILY/DUPLEX ❑MULTI -FAMILY ❑ INDUSTRIAL O COMMERCIAL
USE
TYPE
OCC
SQ.FT.
VALUATION($)
¢XISTING USG
EXISTING SF
NEWFLODRSP
PORCHSF
DECKSP
DEMOSF
STORIES9
TOTAL NET Sr
REMODEL
REMODEL KITCHEN
REMODEL OTHR
GARAGE D ATTACHED
BATHROOM SF
SF
SF
SP O DETACHED
EXISING ❑YES
FIRE SPRINKLERS O NO
EICHLER OYES
D NO
SECOND STORYADDITION OYES
D NO
DWELLING
SECOND DWELLING OYES ❑ ATTACHED O DETACHED OTHER
UNITS 9
UNIT ADDHON: ONO 5 F
POOLS D FIBERGLASS O VINYL -LINED ❑ GUNITE O PREFABRICATED
POOL -SA 3PA-SP I SPAATTACHED DYES ❑ NO TOTAL -SP
IiECEI
Cmnn¢'ciul or Muld-F,,rily Buildines mih Public Svoimtive Pools rxl,'r'o Denatent olEEVhn, e1aI Heath apuroval
]TOTAL
RH-ROOP EXISTTNGROOFTYPE: E] BUILT OF ROOF El ASPHALT SHINGLES[] WOOD SHAKES ❑WOOD SI TINGLES❑TILE OTHER(SPECIPY)
REMOVE /REPLACE ❑NO
IFNO
PLYWOOD ❑'h.. ❑3/8',
PLYWOOD TYPE:
PITCH:
CLASS
E]yFS
NOF LAYERS
TFIICKNESS❑5/B" OTHER
❑OSB El COX OTHER
•12
(ROOF
A
PROPOSED ROOF TYPE: OBUILT-UP ROOF OASPHALT SHINGLES O WOOD SHAKES OWOOD SHINGLES DOTHER
*Provide a signed copy of the Cupertino's Tear -Off Policy SP #ot 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 iudormation 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 building construction. I authorize representatives of Cupertino to
enter the above -identified property for inspection purposes. I acknowledge and authorize all information contained On this application form
to be made available for public record.
Signature of Applicant/Agent: cnasw>, via,a Date: 10/05/17
SUPPLEMENTAL INFORMATION REQUIRED
"New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction.
"Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
"Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
'HOA -Provide a letter of approval from the Home Owner's Association
B1dgApp2017.doe revised 087D1717
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