B-2018-1209 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1209
11752 TRINITY SPRING CT CUPERTINO,CA 95014-5146(366 53 039) SUNRUN
INSTALLATION
SERVICES INC
SAN LUIS 0B1SPO,CA
93401
OWNER'S NAME:Chan Elaine Sm And Steve DATE ISSUED:7-23-2018
OWNER'S PHONE: PHONE NO:(415)580-6900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=46 Lic.4150184
Contractor SUNRUN INSTALLATION SERVICES INC Date 06/30/2020 X BLDG X ELECT—PLUMB
I hereby affirm that I am licensed under the 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 and effect. JOB DESCRIPTION;
(N)25-PANEL ROOF MOUNTED PV SYSTEM(7.2kW);(N)SUB-
I hereby affirm under penalty of perjury one of the following two declarations: PANEL(100 AMPS)
n. 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
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
(J✓ Section 3700 of the Labor Code,for the performance of the work for which this
f permit is issued. Sq.Ft Floor Area: Valuation:$13464.00
APPLICANT 'FRTIFICATION
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 366 53 039
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 PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulationfs
Date 07-23-2018 Issued by:Haley McKee
D ate:7-23-201 S
OWN DECLgtRA•ION
I hereby affirm that I am a pf from the Contractor's License Law for one of the RE-ROOFS:
fallowing two reasons; All roofs shall be inspected prim to any roofing material being installed.If n roof is
n. 1,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
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2, f,as owner of the property,am exclusively contracting with licensed Signature ofApplicanC
contractors to construct the project(Sec.7044,Business&Professions Cade), Date:07-23-2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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
performance of the work for which this permit is issued HAZARDOUS MATERIALS DISCLOSURE
z 1 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 9.12 and the
s. I certify that in the performance of the work for which this permit is issued,1 Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous
ontannintants as defined by the Bay Area Air Quality Mang ement District I
Worker's Compensation laws of California.If,after making this certificate of will maintain compliance with the Cupertino Municil, d61511 erand
exemption,I become subject to the Worker's Compensation provisions of the the health&Safety Code,S ctio s 25505 5 0125534.
Labor Code,I must forthwith comply with such provisions or this permit shall /�/� � ✓ '
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:07-23-2018
1 certify that I have read this application and state that the above information is CONSTRUCTION LENDIJAGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction 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 9.78. understand my plans shall be usetl as public records.
Signature Date 07-23-2018 Licensed