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B-2018-1232 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:13-2018-1232 7748 SQUIREHILL CT CUPERTINO,CA 95014-5017(362 23 028) TESLA ENERGY OPERATIONS,INC. FREMONT,CA 94555 OWNER'S NAME: Liu Yuchen Trustee&Et Al DATE ISSUED;08/16/2018 OWNER'S PHONE:408-457-1828 PRONE NO:(650)68 1-5 100 LI DECLARATION BUILDING PERMIT INFO: License Class B C10 C46 Lic.# 8 0 Contractor TESLA ENERGY OPERATIONS,INC.Date 12/31/2018 X BLDG—ELECT—PLUMB 1 hereby affirm that I nm licensed ander the provisions of Chopter 9(cmnmencing —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)EV CHARGING STATION(60 AMPS)-GARAGE I hereby affirm under penalty of perjury one of the following two declarations: r. I have and will maintain a certificate o£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 Section 3700 of the Labor Code,for the performance of the work for which this T, permit is issued. Sq.Ft Floor Area: Valuation:$1500.00 APPIJGANT 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 Typo: and slate laws relating to building construction,and hereby authorize 36223 028 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 regul tint per tf a Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 08/16!2018 Issued by:Jasmine Archbold Date:08/16/2018 OWNER- HPDERDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one at the RE-ROOFS• ]'allowing two reasons: All roofs shall be inspected prior to any roofing materiel being installed.If a.of is r. 1,as owner of the property,.,my employees with wages as their sole installed without first obtaining an inspection,1 agree to remove all new materials for ampeneation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Cade) z. 1,as owner of tine property,am exclusively contracting with licensed Signature of Applicant: contractor to construct the project(Sec.7044,Business&Professions Code), Date:08/16/2018 1 hereby affirm corder penalty of perjury one of the following three declarations: ALL ROOK COVERINGS TO BE CLASS"A"OR BETTER r. I have and will maintain a Certificate of Consent m self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance,as at for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the perfmmr—of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534.1 will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the s. I certify that in the performance o£lhe work for which tris permit is issued,l health&Safety Code,Section 25532(x)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the rnaterad.Additionally,should I use equipment m•devices which emit hazardous air Worker's Compensation laws of California.If,alter makin this certificate of contaminants as dented by the Bay Area Air Quality Management District I I g will maintain compliance will)the Cupertino Municipal Code,Chapter 9.12 and exemption,t become subject to the Worker's Compensation provisions of the the Health&Safety Code Sections 25505 5533,and 25534. Labor Code,l must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:08116/2018 I certify that I have read this application and state that the above information is C T LENDINGAGENCY correct.I agree to comply with all city and county ordinances and stale laws I hereby affirm that Cher -a onstruction 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 ARCHIT'ECT'S DI CLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Data 08/16/2018 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT®BUILDING DIVISION 0 10300 T'ORRE AVENUE a CUPERTINO,CA 95014-3255 (408)777-3228® building@cupertino,org PEMIT uB-2 0 rwUPF,RTINO REV It DEFN_ NEW CONSTRUCTION [I ADDITION 4ALTERATION❑T.I. Lj MEP E]RE-ROOF SWIMMING POOL/SPA PROJECTADDRESS APN1 4% SUL L /�5 ©(y 7748 S uirehill Court OWNIIR NAME PHONE E-MAiL Ra e Lu (408)4,57-1828 STREET ADDRESSCITY,STATE,ZIP 7748 Squlrehlll Qourt Cupartlno,CA 95014 ©CONTRACTORNAME ❑OWNER-BUILDER COMPANYNAMB LICENSE NUMBER LICENSE TYPE Christina Vlerra(Agent) Tesla Energy 888104 B,C10,C46 STRERTADDREII CITY,STATE,zIP 391 Faster City Blvd Foster Clty,CA 94404 HMAIL PHONE EUS.LIC N cvierra@tosla.com 610-925-5655 888104 Q ARCHITECT El OWNER❑OWNER AGENT❑CONTRACTOR AGENT❑ENGINEER❑DEVELOPER[1,raNANT CONTACT NAME LMA SAME AS CONTRACTOR _ STREET ADDRESS TH,ZIP PFSONII Install Electric Vehicle Cher N SINGLE-PAMILY/DUPLEX nmuLT1-FAMILY [3 INDUSTRIAL r]COMMERCIAL 11111TINO USE EXISTING SP NEW FLOOR SP PORCII SP I DECK SP DEMO SP 1'TOME'I I TOTAL 119"11 USE TYPE OCC SQ.PT. VALUATION 0) REMODEL REMODEL KITCHEN RRMODELOT'HR GARAGE ❑ATTACHED flAT1IROOM SP SF SR - BE [I DETACHED RXISING []YES YES SECONU 9'1'UHY ADDITION ❑YES pICHLER FIRE SPRINKLERS❑NO Q NO ❑NO bWELLINO SECONDDWBLLING L]YgS[]ATTACHHD[1DB'rACHRD OTHER UNITS I UNIT ADDnON: El NO 5 P POOLS []FIBERGLASS El VINYL-LINED[1 GUNITR L]PRIIPABRICATRD POOL-SF SPA-SF—I SPAATTACHEO❑YES ❑NO I TOTAL-SP RECEIVG Y; 'TOTAL VALUATION: cos.—!,i T M fE-P 1!"DA1ll f ultl P011c P011SwIrrJ118 Poel,req lm D-N ur tolFr vtror to tnl troth nnyrounl RE-ROOF BXISTINGROOPT'YPE: ❑BUILT-UPROOP❑ASPHALTSHINGLES ]WOOD SAAKES❑WOOD SHINGLES❑ LR OTHER(SPECIFY) RRMOVH/REPLACE�NO IP NO PLYWOOD❑'A ❑316" PLYWOO➢Typg, PITCH`'1n ROOF CUSS i]YBS POP LAYEILS---- THICKNM905)E" OTHEk_�,,, []OSB ]]CDK OTHER_ .4 A PROPOSEDROOFTYPE:nOUILT-UPROOP©ASPHALTSHINGLES E1WODDSIiAKES l7WOODSHINGLES Elm4ER__— *13ovide a signed copy of the Cuper'tino's Tear-Off Policy SP uuI SQUARMs 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 information I have provided is correct. I have read IITe 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 chenunaur fra_ .Is::Y;;w`"'"rdor Date:7/23/2018 SUPPLEMENTAL INFORMATION REQUIRED" *New SPD/Second Dwelling Unita/Mu ILiterally Dwellings:A Deraollbon pormit is required prior to issuance of a building permit for all new construction, *C.'aracrelnl 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 BidgApp 2017,doc revised 08101117