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12060015CITY OF CUPERTINO BUILDING PERMIT--., BUILDING ADDRESS: 11497 LINDY PL OWNER'S NAME: LICENSED CONTRACTOR'S DECLARATION License Class 6 Lic. N Contractor rl`F .5/lit,><2c.-ow Date 0 9 r7 2) "— . hereby affirm that I am licensed under 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 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. 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of th' permit. Additionally, th applicant understands and will comply with all ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 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. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.J8. CONTRACTOR: THE SOLAR COMPANY, PERMIT NO: 12060015 INC 20861 WILBEAM AVE STE 1 DATE ISSUED: 06/18/2012 CASTRO VALLEY, CA 94546 PHONE NO: (510) 214-9005 BUILDING PERMIT INFO: BLDG r ELECT f— PLUMB r MECH r RESIDENTIAL r- COMMERCIAL r JOB DESCRIPTION: GROUND MOUNTED PHTOVOLTAIC SYSTEM 5.2KW GRID TIED 8/7/2012- REV#1 - REVISE STRUCTURAL ANALYSIS FOR SOLAR PANELS -REVN1 ISS'D 8/7/2012 Sq. Ft Floor Area: I Valuation: $25000 APN Number:35624006.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DA:7 LAST CALLED INSPECTION. Issu Date: WWI 41y/ RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safe Code, Sections 25505, 25533, and 25534. O --- Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION Signature Date I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 11497 Lindy Pi DATE: 08/07/2012 REVIEWED BY: Sylvia AN: BP#: 12060015 VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1GENRES PERMIT TYPE: WORK Revision #1- revise structural anal sis for solar panels SCOPE p1w);h. Phv. C'hf2f A Elec. Mao Chc-cl Ads h. Perri'::! i car: Phtmh. Permit Fc,.e: Elec. Perttril 0/her Plumb ln.ypLi 11,her E7er. L­ Li Plumb, hrsp. Pee. /;lr(. Imp. l'rc NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These Pees are based on the Dreliminary information available and are onlv an estimate. Contact the Dent for addh7 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 1 7 hours Plan Check, Hourly $133.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT Fo.oThrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C'onstruc•tion Tax. _Administrative Fie: Q E) Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 Q i Y,r<riv) Fees: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $133.00 TOTAL FEE: $133.00 Revised: 07/01 /2012 I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 11497 LMDY PL I CO TRACTOR: THE SOLAR COMPANY, I PERMIT NO: 12060015 INC OWNER'S NAME: ❑ LICENSED CONTRACTOR'S DECLARATION License Class 6 Lic. tl�,�,/��il j Contractors Sou9l,- � soTu y mate a�- I hereby affirm that I am licensed under the provisions o 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 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. 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which m against said gTin consequence of the granting of th' i . A i ly the plicanunderstands and will comply with non - 4l'/S ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 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. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 20861 WILBEAM AVE STE I I DATE ISSUED: 06/18/2012 CASTRO VALLEY, CA 94546 PHONE NO: (510) 214-9005 JOB DESCRIPTION: RESIDENTIAL u COMMERCIALU GROUND MOUNTED PHTOVOLTAIC SYSTEM 5.2KW GRID TIED Sq. Ft Floor Area: I Valuation: $25000 APN Number: 35624006.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: J-4441 % 4 - Date: 657 X . 12— RE-ROOFS: 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. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Xe or authorized ag Date -- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess Signature. Date CITY OF CUPERTINO ro. FEE ESTIMATOR - BUILDING DIVISION lalADDRESS: 11497 lindy place DATE: 06/04/2012 REVIEWED BY: larrys APN: BP#: `VALUATION: 1$25,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: I PENTAMATION SOLAR-RES I PERMIT TYPE: WORK round mounted photo voltaic system, 5.2 kw, rid tied SCOPE im Check PIWO Plrtn UTA'A Elea. Plan Ch'vk h. I"i. r„rrr Prt•. Pr '.i .l� c. F',, rat, it (c . Other kfevh. Jr: 01her Plumb Irrsp. f 1her lace . h. Phrurb. h;.lt. rev, NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta). These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E-f 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =# $214.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 1 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 i 0 TrcrsrrI Doe_:rrtn,,niatiorr Fces_ Stronp- Motion Fee: IBSEISMICR $2.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $3.50 $214.00 TOTAL FEE: $217.50 Revised: 05/01 /2012