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12030065CITY OF CUPERTINO BUILDING PERMIT"'" "v-��- BUILDING ADDRESS: 10500 MIRA VISTA AVE CONTRACTOR: SOLARCITY PERMIT NO: 12030065 OWNER'S NAME: SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 1N LICENSED CONTRACTOR'S DECLARATION License Class CIA LichId V Contractor I hereby affirm hat I a li used under the provisions of Chapter 9 (commencing with Secti 000) 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. 1 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. Addition ly, the aplicant understands and will comply 9.18. with all non-pointsourc� regulates per the Cupertino Municipal Code, Section �� '��' / 11 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) 1, 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, 1 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. BUILDING PERMIT INFO: BLDG r— ELECT F_ PLUMB r MECH F RESIDENTIAL F COMMERCIAL F JOB DESCRIPTION: INSTALL SOLAR PANEL AT EXISTING SINGLE FAMILY DWELLING ROOFTOP. WITH STRUCTURAL 4/5/2012 -REV# I UPGRADE MAIN PANEL TO 225 AMP AND RELOCATE THE PV EQUIPMENT INTO THE GARAGE4/5/2012 REV# I ISS'D Sq. Ft Floor Area: I Valuation: $57200 APN Number: 35704028.00 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: Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material berg 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. 1 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 w4 the Curprtino Municipal Code, Chapter 9.12 and the Health & Safety Code, ctions 2 05, 25533, and 25534. L. Owner CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of wrk'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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10500 MIRA VISTA AVE I CONTRACTOR: SOLARCITY I PERMIT NO: 12030065 I OWNER'S NAME: I SAN MATEO, CA 94402 I PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION License Class l) Li.. k 7 Contractor J — Z Z�% I hereby affir that 1 am li64) ed under the provisions of Chapter 9 (commencing with Section of Division 3 of the Business & Professions Code and that my license is in full force and effect. 1 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 this permit. Additio Ily, the applicant understands and will comply with all non -point source regulates per tflk Cupertino�unicipal Code, Section 9.18. / /% / ❑ OWNER-61UILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one or the following two reasons: 1, 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 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. BUILDING PERMIT INFO: BLDG F ELECT r PLUMB F MECH i RESIDENTIAL ii COMMERCIAL r JOB DESCRIPTION: INSTALL SOLAR PANEL AT EXISTING SINGLE FAMILY DWELLING ROOFTOP. WITH STRUCTURAL Sq. Ft Floor Area: I Valuation: $55000 APN Number: 35704028.00 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: ��%� Date: j. ,o;1cP •/a 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 1 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 & Safety Code etion 505, 25533 and 25534. Ow CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of mork'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. Signature Date I Licensed CITY OF CUPERTINO FM-7 FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10500 Mira Vista Ave DATE: 04/05/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: 1$2,200 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1 REAP2 PERMIT TYPE: WORK Revision #1: Upgrade main panel to 225 amp and relocate the PV equipment into the garage. SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1ERT<200 100 Amps $44 TOTALS: $44.00 Plum Cbcc-A Elec. Plan Check 0.0 hrs $0.00 f'lan,l� /' rm�l I ��c: Elec. Permit Fee: IEPERMIT (hC--r Mf!ch- 111`p 0(hur plumh ln:qLi Other Elec. Insp. 0.0 hrs $44.00 h. liml). I n c: !"'hweh 1,1.y. Fr,•: Flec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef, 711111) FEE QTY/FEE MISC ITEMS Plart C'hcek Fee: Suppl. PC P e e PME Plan Check: $0.00 l'�•f'1r.i( 7'�r: Suppl, hrl p Fee PME Unit Fee: $44.00 PME Permit Fee: $44.00 ".:'.virliction Tax. Administrative Fee: IADMIN $41.00 Work Without Permit? 0 Yes 0 No $0.00 I fI1,111d',A/ Plamiiny Fc vs: Travel Documentation Fee: ITRAVDOC $44.00 Strong Motion Fee: IBSEISMICR $0.50 0.5 hr Admin./Clerical Fee ?/ 22 .00 1ADMIN t r Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $174.50 $41.00 TOTAL FEE: 215.50 / Revised: 1 /19/2012 NF��,,�� CITY OF CUPERTINO *72 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 10500 mira vista ave. DATE: 03/14/2012 REVIEWED BY: bobs. APN: % BP#: "VALUATION: $55,000 `PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION SOLAR-RES PERMIT TYPE: WORK install solar panel at existing sfd rooftop, w/structural. SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Aictrirt vJr. l_ Thoce Fvoc nry hncvd nn lhv nrvlininnn� infnrmnilnn nvnilnhly and nry nn/v nn vcHmnla ('nnJn�J Jhv I)vnJ for nddn'1 info_ FEE ITEMS (_/'ee Resolution 11-053 A ' . 7// 111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F 1-1 # $214.00 Alternative Energy System IPHOTOVRES Photovoltaic System Suppl. PC Fee: e Reg. OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes (j) No $0.00 Advanced Plannine Fee: $0.00 Select a Non -Residential Building or Structure G 0 Strom Motion Fee: IBSEISMICR $5.50 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC 1 $3.00 SUBTOTALS: 1 $8.501 $214.00 TOTAL FEE: $222,50 Revised: 111912012