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BLD-2020-0718BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 910 OLD TOWN CT Cupertino APN: 356 11 040 PERMIT NO: BLD-2020-0718 CONTRACTOR: SUNRUN INSTALLATION SERVICES INC, 225 BUSH STREET STE 1400 SAN FRANCISCO CONTRACTOR PHONE: DATE ISSUED 6/2/2020 10:24:16 AM ISSUED BY: JASMINE ARCHBOLD VALUATION: $8360.00 JOB DESCRIPTION SYSTEM - (4.4 KW) (N) 14-PANEL ROOF MOUNTED PV LICENSED CONTRACTOR DECLARATION B GENERAL BUILDING CONTRACTOR, C39 ROOFING 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full CONTRACTOR: SUNRUN LICENSED C10 LICENSED 750184 EXP 06/30/2020 I hereby force I hereby INSTALLATION SERVICES INC CLASS: ELECTRICAL, A GENERAL ENGINEERING NO: DATE: affirm that I am licensed and effect. affirm under penatiy of I have and will maintain a certificate for which this permit is issued. I have and will maintain Worker's I certify that in the performance laws of California. with such provisions or this CONTRACTOR, C46 SOLAR, under the provisions of Chapter perjury one of the following of consent to self Compensation Insurance, of the work for which If, after making this certificate permit shall be deemed three declarations: -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith revoked. V issued. Compensation comply HAZARDOUS MATERIALS DISCLOSURE Chapter 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 Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Sections 25505, 25533, and 25534. for this project. 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 and state that the representatives of this city liabilities, judgements, will comply with all non -point above information is correct. I agree to comply with all city and county ordinances and state laws relating to building to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, source regulations per the Cupertino Municipal Code, Section 9.18. I certify that I have read this application construction, and hereby authorize harmless the City of Cupertino against the applicant understands and 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.