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B-2018-0847 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0847 7464 STANFORD PL CUPERTINO,CA 95014-5815(35932017) SUNPOWER CORPORATION SYSTEMS RICHMOND,CA 94804 OWNER'S NAME: DATE ISSUED:05/17/2018 OWNER'S PHONE: PHONE NO:(941)720-3850 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO', License Class 13 Lic.#890895 Contractor SUNPOWER CORPORATION SYSTEMS Dale 02/28/2019 X BLDG_ELECT_PLUMB 1 hereby affirm that I am licensed underthe provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force xad effect JOB DESCRIPTION: (N)21-PANEL ROOF MOUNTED PV SYSTEM(7.56 KW) 1 hereby affirm under penalty of perjury one of the following two declarations: r. 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 .r, 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 Arca: Valuation:$10000.00 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'I'ype: and state laws relating to building construction,and hereby authorize 359 32 017 representatives of this city to enter upon the above mentioned property for inspectlon.purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,casts,and expenses which PERMIT EXPIRES IF WORD IS NOT STARTED may accrue agains said City In consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, a�ap ant on erstands and will comply with all non-point source reg atiod p the entire Municipal Code,Section 9,18. 180 DAYS FROM LAST CALLED INSPECTION. Signature �+� `—� Date 05-17-2018 Issued by:Kim Dunbar Date:05/17/2018 OWNE F, DF.CLARATf thereby '-rm th 1 nm exempt]'ram the Contractor's I,Veensc Lmv for one ol'thc RE-ROOFS: ]'allowing two reasons: All roofs shah be inspected prior to any roofing material being installed.If a roof is t. [,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,l agree to remove all new materials for compensation,will do the work,and the structure is act intended el offered for inspection, sale(Sec.7044,Business&Professions Code) z 1,as owner of the property,am exclusively contracting with licensed Signature efApplieant: contractors to construct the project(Sce,7044,Business&Professions Code). Date:05-17-2018 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS'I.O BE CLASS"A"OR BETTER t. 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance,as provided far by I have read the hnzardoos materials requirements under Chapter 6.95 of the Section 3700 ofthe Labor Code,for the performance of the work for which this Cnitrornia Health&Safefy Cade,Sections 25505,25533,and 25534.l will permit is issued. maintain compliance with the Cupertino Municipal Cade,Chapter 9.12 and fire a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should I store or handle hnzardoos sha11 nm employ an on in an manner so as to become subject to the naterial.Additionally,should I use equipment or devices which emit luxurious p y• y pars y J 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 Cupertfn Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the healt�t'Settion 550 25533xnd 25534. Labor Cade,f must forthwith comply with such provisions or this permit shall be deemed revoked, Owner or authorizVAPPLICANT CERTIFICATION Date:05-17-2018 I certify that I have read this application and state that the above information is Zcorrect.I agree to comply with all city and county ordinances and state laws I hereby affirm that tuction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which thued(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 DECLARAXION Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date 05-17-2018 Licensed Professional