BLD-2019-1467BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10290 STERN AVE Cupertino
APN: 375 14 035
PERMIT NO: BLD-2019-1467
CONTRACTOR:
NEXUS ENERGY SYSTEMS INC, 2810 HARBOR BLVD STE 201 OXNARD
CONTRACTOR PHONE:
DATE ISSUED 12/2/2019 4:18:13 PM
ISSUED BY: JARCHBOLD
VALUATION: $18000
JOB DESCRIPTION
-PANEL (125 AMP)
NEW 17-PANEL ROOF MOUNTED PV SYSTEM (6.2 KW); NEW SUB
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
NEXUS
LICENSED
B GENERAL
LICENSED
359060
EXP
07/31/2021
I hereby
force
I hereby
ENERGY
CLASS:
BUILDING
NO:
DATE:
affirm
and effect.
affirm
I have and
for which
I have and
I certify that
with
SYSTEMS INC
CONTRACTOR
that I am licensed under the provisions of Chapter
under penatiy of perjury one of the following three declarations:
will maintain a certificate of consent to self -insure for
this permit is issued.
will maintain Worker's Compensation Insurance, as provided
in the performance of the work for which this permit is
laws of California. If, after making this certificate of exemption,
such provisions or this permit shall be deemed revoked.
Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
for by Section 3700 of the Labor Code, for 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
I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
Chapter
Health & Safety
as defined
Sections
for this project.
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under
the Cupertino Municipal Code, Chapter 9.12 and the
V
with
equipment
Municipal
Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
Firm Certification No:
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
v
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address:
I hereby
Yes
affirm
under penalty of perjury that there is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
above information
to enter
costs, and
source regulations
is correct. I agree to comply with all city and county ordinances and state laws relating to building
upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep
expenses which may accrue against said City in consequence of the granting of this permit. Additionally,
per the Cupertino Municipal Code, Section 9.18.
I certify that
construction,
harmless
the applicant
:
I have read this application and state that the
and hereby authorize representatives of this city
the City of Cupertino against liabilities, judgements,
understands and will comply with all non -point
Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 365 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period
of 365 days after the time the work is commenced.