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BLD-2020-0330BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: undefined APN: 356 04 035 PERMIT NO: BLD-2020-0330 CONTRACTOR: undefined CONTRACTOR PHONE: undefined DATE ISSUED 8/13/2020 5:15:41 PM ISSUED BY: haleym VALUATION: $48500 JOB DESCRIPTION WALL ENERGY STORAGE SYSTEM (40.5 KW); (N) LOAD CENTER PANEL (200 AMP); (N) LOAD CENTER PANEL (125 AMP). (N) SOLAR ROOF (258 TILES) (15.2022 KW); (3) TESLA POWER LICENSED CONTRACTOR DECLARATION 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full CONTRACTOR: undefined LICENSED undefined LICENSED undefined EXP undefined I hereby force I hereby CLASS: NO: DATE: affirm and effect. affirm I have and for which I have and I certify that with that I am licensed under the provisions of Chapter under penatiy of perjury one of the following will maintain a certificate of consent to self this permit is issued. will maintain Worker's Compensation Insurance, in the performance of the work for which this laws of California. If, after making this certificate such provisions or this permit shall be deemed revoked. 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 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 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, Chatter 9.12 and the Health V with equipment Municipal & 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. or devices which emit hazardous air contaminants Code, Chapter 9.12 and the Health & Safety Code, EPA LEAD -SAFE DISCLOSURE for this project. Firm Certification No: An EPA Lead -Safe Certified Renovator will be responsible Firm Name: No EPA Lead -Safe Certified Firm is required for this project. V Certified 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 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 construction, harmless the the applicant Signature: have read this application and state that the and hereby authorize representatives of this city City of Cupertino against liabilities, judgements, understands and will comply with all non -point 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.