13110034 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10038 OAKLEAF PL CONTRACTOR:SOLARCITY PERMIT NO: 13110034
OWNER'S NAME: THE KHESING AND WU WANYI 3055 CLEARVIEW WAY DATE ISSUED: 11/06/2013
OWNER'S PHONE: 4089961633 SAN MATEO,CA 94402 PHONE NO:(650)638-1028
ICENSED CONTRACCTTTOR'R'S�D�ECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL[]
LKe .Class Lic.# 2�all INSTALL 17 ROOF-TOP FLUSH MOUNTED SOLAR
PANELS
Contractor Dat4.25KW
I hereby affirm that I am licensed Wnder 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
erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$17000
ve and will maintain Worker's Compensation Insurance,as provided for by
'tion 3700 of the Labor Code,for the performance of the work for which this APN Number:32618060.00 Occupancy Type:
ermit 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 WIT�IIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS F LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses.which may accrue against said City in consequence of the /�do / 3
granting of this ermit. Additionally,the applicant understands and will comply Issued by: Date:
with a point source reg ns per the Cu ertino Municipal Code,Section
9.
. ��;
RE-ROOFS:
Sign Date /� ` All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ WNER-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)
1,as owner of the property,am exclusively contracting with licensed contractors to 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.I2 and the
declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous
I 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
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,See ' nd 25534.
Section 3700 of the Labor Code,for the performance of the work for which this _e 3
permit is issued.
Owner or authori Date:
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 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,l 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
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: /av3S a DATE: 1110612013 REVIEWED BY: mendez
APN: BP#: `VALUATION: $17,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: SOLAR-RE i
WORK install 17 roof-top flush mounted solar panels 4.25kw
SCOPE
,lfech. Plan Check NwO, Plum Check Elec..Plan Check
Lti>ch. Permit Fee: PGlmh. pe mit Fee: Elec: Permit Fee:
Other Alech. Insp. Li I Other Plumb Insp. Li 1
Other Elec.Insp.
,41ech.Insp.N'ee: Plwnb. Insp. Fee: Elec.Insp.Fere:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Alternative Energy System
Suppl.PC Fee: 0 Reg. OT 0.0 1 hrs $0.00 $229.00 IPHOTOVRES Photovoltaic System
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
Construction Tax:
,ldrninistrative Fee:
Work Without Permit? Yes No $0.00
Advanced Plannin Fee: $0.00 Select a Non-Residential
Travel Documentation Fees: Building or Structure
Strong Motion Fee:. IBSEISAffCR $1.70 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $2.70 $229.00 TOTAL FEE: $231.70
Revised: 10/01/2013