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12020019 CITY OFC UPI+RTIN LTIL -_ING PIPJ' IIT IjUIC;DINGAD DRESS; [0. 1�Tf2CSSLEI2.CT CCDNTR�GTO[2 GREEN`IEAI S®C:�Rc( PLRRIIT;NO:.12020014 • ELECTRIC, - OWNEWS NAME: K ANG TAE`.TRUSTEE&.ET AL '667 N C2TH ST PATE ISSUES 0_>i00/2012 05i!NECi S PH®N E:-4059666094 SAN JOSE",C'a 9 5112 ; !'ItQNE NQ:. (tti8j 01474 LICENSFID CONTRACTOR'S DECLA ATION; t _ K i[LVIIIC.P.E 11I[T LNFO 9L I)G """ ELE.CT PLUMB :License Class .0 Lie.#. 5 S� 2 r d �€ Gontrictor- CZt P2�t Lei ` RESIDE,� ,i I ®NI M' •ER-_C IA LYIEiiC o�a/ Date JOB IDFS+(✓RIPTtO! [NSALL,4dEM;NQ 3.�TPERY ST�+3 AGEihereby=affrmthat,famaicens� nehwnsfoChapter9 MW SOLAR SYST (conuuencin:7000).of Division i;ofthe Busiire.ss&`erofessions OF Coife andAhat mv�rcense',isiin full force ancDseffec't. ANY:k[ND Vhereby-attirm tinder penalry.�of;perjury one:'ofthe frfllo»nrg hyo tDeclarati®_r`is: 'I have and will nmi4tvlh 3 certiewate of,conse€iYtn;self-encu"re;for VJurlcer's Coinpensa-tion,as.provided_,for'by.Saciioii x700 of.the Labor Code,f_tm the _ °perforFnuice ot.the-workfor.whichttfiis;�:iernutis-issued`.. I have and avilLnraintnin;Worker's Gompensation.lnsurincc;as provided for by Section-3100'ofiliesLab�rCode,:fortlte�,j.let•tomr�Snca'ofalfe�workforevhichtJiis &rmtttsi"sued. Sq.FtFlo6r-Area: Valutation:$16200 APPLICANT`.CFRTIFWATION; ar p clition and staW fel at the above irif nnatibu-is APN Nu inber:3 6070$0;00. Occrtp,incy Type: :co eI tt_ lagreeto;comply wilh.alf city and courtword inanccsaar4r5tnt61aws rel_itin to buiiidingconsuuction,and hereby authorize representatives of this cityto entee- - - upon the;abova,mentit�nzd piuperty tc?r IEispectioiripitrposesi,"(sWe)"ageez to�save indemnify and keep ha nntess the Ctty ofCupert€no aeauist?Eiabd€ties,judgmeirts' PERhIIT'EXPIRES 11F WORK IS NOT STARTt casts and'exp uses wfir�h mly ac me against s ird+'t,rry in consequenceur the _ grariUng ofalrrs,permit:,.Addttioia�ll},the plrcanE;imderstands and'}Jill comply, WITHIN 199 Y. &OP PERN`Iff ISSUANCE OR with'all;noir-ptiirrt source re Iasi rsrper ie Cupertino htunicifzal Code Sectiotr 'N -S FROM ST CALLE ,I'NSPECTION. 9:P8. Signattiire- 'Bate- Issued'uv; - _ Date: 0 `OYVNER=BUIL DER DECLARATIciiy I herebyaftiruuthat Lam exemptIrom the Contractor's Lice.n e,LaW Tor;one ofRE GOOFS: the f61Jriwielg t)yo reasons: All r6rfs§half be tilsiiected liiio�to any roof nguinaterial'beiig,installed,tfwr1Q.rf:is [;as,owner.ofthe;property;or'riiyxeiiaployeesrv4ithwtges as thele Sole conq?en�aFion; insi alle2l.withoi$` "st obtaining an i'nspeciion„I agree to,remove all new materials for vvilhdo the•tvoik;and tliestruCture isnot intended'or offered for.saE'e=(Sec:7044, inspection. Business,&Professions(_2ode) , Signatureof,Appiicant- °t,as ovvttei4of the properri:girl exclusively,contracting with;l_i_�egsed contra tprs:fo = couserucf the pr0JegCL(Sec:7644,,13usmess:&'Professions Code). J hereby affirm ander lienalty,of"perjury juf+y otie of fhe foil®wuYg'three; ALL ROOF COVERINGSI BE CLASS"A”OWBET LR - . _.... - declarations: - , have and tiVillniaintain alCertiftcate o'ftCunsent,`to^� [f-insure for°Worker=s !Compensation;as,provided-tor,by`Sectlon 3700m'the Labor Cude,for the' ii 1'ZAItI}OIJS MATFftIACS DISCLOSURE 'perfoinvance�ol the work I have"read,the taazardouctm zkera els requti eriaents�undei Cliapter-;6:95 of the_ CidiformaMealth�&Safer}Code,.S&Aalis 25505 155 3 tail 25534.I w ll in i'utain 'I have and.will mari5taiia Workar's Coitipensatiun;In�ulartce,as provided rr by m - -- Section;3700ut ihe;F�aborCode',furtlie�ierfortnanee�of the�wotk�for vJhicli flies comphan'cetwfttr,the Cupei tinoManicipai Codi;Ctrapter 9.12 tail the 1{ealth;Si _ .. _.-. .. _[ _- Safety"Code,Section'2553z(5)should 6' 6r a or handle Fitz ard6us m°at&ial.. perrnif is;isst.ted. Addthonailys;ttould;I use eyuipmentfor devic6',whtch:eintt liazardous air I certify iliat.in the performance uf_the)viirk.forwhich;this`periiitf t'sitsstied,I shall i6ase�nbBAreaAtrtQuality 6anagenfeu'tbisteictidE ['ysilk atief�oriigloy,any,peesciii ii'ttany--aiaiiner ,so,as;to,liecornersubjcctto the Worker's ;-rriarntaiiircorup[tance viith;"fife Cypertiuo�Miinicipal C(oale;kt'tisepter 9,.12,Itnd tate Compensation Iaws,ofGal ifort)ia., If,afler rnal:ing;tlits,ceitificate.ofexeniption,,f Health¢&Saif' .Cisife;,Sec(iotis-25565,;25-533;.a(id 25534, become subject to the"Worker's Coaupehsataou prov-"Isions of the Labor C ode;I must O -e c. ori .d aaent: fsrthwith'com l} yrtfi.sueh_ rgvtsions;or,thts erriiit shall be deemed fcvoked'. 0216 p P - p Date: 6��1z. APPI.If tNT C'EI2TIF'ICATIOlY CONSTROJION LENDING'AGENCY 1.cerOy4hat 1-have reait:this ipf lreafion and sia£e'that the aliove€rnfornaatrori is . correct.1"agree4tu comply w,th.all c ityYan l_cnu_rity ordmaraczs and`si te.laus,r"c4ihnj;? ,I hereby affirm that`Ehere.tsra,construcfibia Iendiiig,ageircv°forttie peiformancc of_cork's foiwhr h,this er 'ter ' - upoll!, mentionedproperty,,far•rhs ect€nn' ur oSes.==We agree to,cave Lender,sNati[e �- 09 Civ,Cl to::butldan ''constru E_ion anti hereby auehbrize represent atives of this�rtv to'enter p•Hitt rsttssue. P p p P ( ) ec u}demnrty,and keepafarmlescrtfie Crryof:C,upertrno against Itabrhties;,iudgmente, costs and, xp�n�es which enay accrue,agatnst sai&0ty inconsequence oftthe [en<Ier'stAildress. _ rantiii of thls'fiermit: dditioiral[y,theappficantundersfandt?nd'tvill comply �3iFh all pori,point;Source:regulafions'fier[heCupettmo N4uuiclpal_Co<Ie Section ARCHITECT'S°DECLN .9013'. . I un1ers6lnd my plans�shall°be°used€,as.publicir-ecords, Signature_ Date, Cicegsed:Professional .._ _ CTI .E ..'I' F:,E 'TI9I - i�I - N' � NISI'.; N . ._ _ ' , ADDRESS. 10715 TRSSLER"CT IDATE'• REVIEWED � :: 3SC� 0 0 /a?,0., pQ. vALLT No $16,ZOtt, i'EithilT"iYP£: 8WIdiiag Permit' PL�N'LitECic TYPt : Alteration l Repair PRIM,,-t 2Y 2nd�Ui►it: °Yes ia' PG1Yi YI�13Ti4JN` SFD or,Du-lex 1 3SFDREM` IJSF: _- P (iTC'?.' Q"Y.es_, ° ,N® . .PERMIT-TYPE: _ WTLL48OtVCttINSLAR_5YSTM`- .Q'BATTERY-FST?RgtE'QF;, IfVD: :SCOPE TVP OF FLR ARIE.,- C) l�i'ANCZ T�'.PE: CONSTR- . 61.) PG FEES PC PEE ILD' BP FEES E?I FEE,IFS IF3V =eQR-3(CusfarV $(Wo „ TOTALIS I4ECFl,FItJURLaY15Wa des' NQ li'L3�tI3{ CDLI YT QYes } 1VoELIit�IJItLI' FQ Yes QNoi v 8 T U`lttr,..'a, ,. _ ED NnTE.,This•estirnaie�lues'ritrt include feesrdue.io.other I)epartmerttsa(i e.Pltintiing,1'ulilrc 6t'orks,°Fire Sa""nitarv..S`ewer Dfstricii School. Pistrict,.etc):: These. ees°are based on the relineiiu xrri urraiatian,avrritrblesand•are oiil' aii;estinwte: Corifract;tlie Du td ©i^aettfn:.'l in o.__ F EE;I TEIIIS (F.c F e,rc.'iition l:l (153.E,f ?/.1%l i FEETY/,F'EE: MISC` TENTS PI.An-Cheak`Fee: $0':00 _,1, ;# itteniaesue:Energy Sygtdh Supp(._PC Fee.: (� Reg O ®T Q.� Iii°s° 0°00' $214:00' IPffC1T�J�'PES Photcivoliaic System PME'Plan C heck.< $0.00, Perrhi fee: $0,00`= Sf€ppl'. Insp Fee-01 Reg:, 0,0T Pik°tE:Uaiie Fee:= _ __ $0:00: PME'Pe"rm it::Feer $0;'66, r.a Ai `MOk Witliotit Permit? $Q',QQ O „A.UiVdn€ �u Plannk,-,,,ee:. $0.00 Setect'a.Ngtt- 'esidentiat Q r: Mittdtriz or Structure ;'.Strong ktotion:Fee: xBSEIS'r�c k' $1'62 - Setacan Ad€ninistrative Itefn 10*cl Std Co r1i�s€et€ Fee., If3GI3SC $1:00 St7ITOTS $2 2 $214 00 ; TTAL FEE $216.62- 0 . � .,u. . yrs,. Z,._N._. ...... ..., . a .,. Revised: 4/19/2012 CITY OF CUPERTINO SOLAR PANEL PERMIT APPLICATION FORM APN# (� jDate Building Address 1o7i`5;rressler ct: Owner'sName: Tae Kang. Phone#. 408=966;6094 408-691-4743 Contractor: Phone# Contractor;Ucense#, Green.Leaf'Sglar&;Electric Fax #: C-10.-855672 Contact: Uttam Chauhan Phone;#`. 408-4:29-4745 CUpOrtlno Business License#; Fax Job Description: To install a 4:8 kW,Solar System.This System has no'battery storage of any kind. . ot Residential Commercial ❑ Number of Panels/Units: 26� K.jjowatt$. 4.8 STC Dc Valuation (cost of project): co Project Size: Express ❑ S'tandard ❑ Large,❑ = Nlajor❑ Green Points: - , I.2 KW— 6.Points ❑ 2.4 KW— 1'2�Points;_ ❑, 16 KW- 1-8-Points ❑<< Quantity Fee 11) Fee-Description:= - Fee" Permit Type Group 1 SOLARPANL Cottirnercial Solar-Pane:[ E SOLAR-COMM IPHOT,OWOM Photovoltaic>S�ystem E Commercial/Multi-faml ly l BSEISMICO Seismic Comi-inel-cial E IELCPLNCK Plan Check Fee. E IBCBS,C. .Cal Bldg Standards B ALL TERMIT TYPES Commission_.Fee COMM & RESID SOLARRES Residential S0.1.ar Panel E SOLAR-RES : Revised;08/20/2009. CITY OF CUPERTINO SOLAR PANEL 0, PERMIT APPLICATION YDRM - Quantity Fee.ID Fee'Description Fee Permit Type Gro.0 .. 1PHOTOVRES, Photovolta-ic System E Residential I'TRAVDOC Travel & Documentation. B 1BUSLTC Business License B , A