BLD-2020-1262BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20818 HANFORD DR Cupertino
APN: 326 30 063
PERMIT NO: BLD-2020-1262
CONTRACTOR: TESLA ENERGY OPERATIONS INC, 901 PAGE AVE FREMONT
CONTRACTOR PHONE:
DATE ISSUED 8/17/2020 7:53:55 AM
ISSUED BY: haleym
VALUATION: $17000
JOB DESCRIPTION
SYSTEM (24 MODULES)(8.16 kW).
ROOF MOUNTED SOLAR
LICENSED CONTRACTOR DECLARATION
0 ELECTRICAL, C39 ROOFING, C36 PLUMBING
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
LICENSED
LICENSED
EXP
I hereby
force
I hereby
TESLA ENERGY
CLASS: C46 SOLAR,
NO: 888104
DATE: 12/31/2020
affirm that I am
and effect.
affirm under
I have and will maintain
for which this permit
I have and will maintain
I certify that in the
laws of
with such provisions
OPERATIONS INC
B GENERAL BUILDING CONTRACTOR, Cl
licensed under the provisions of Chapter
penatiy of perjury one of the following three
a certificate of consent to self -insure
is issued.
Worker's Compensation Insurance,
performance of the work for which this permit
California. If, after making this certificate
or this permit shall be deemed revoked.
declarations:
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
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
Health
as
Sections
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
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
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
Firm Name:
No EPA Lead -Safe
Certified Renovator will be responsible
Certified
Certified Firm is required for this project.
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is
Lender's Address:
issued (Section 3097, Civil Code).
I hereby
Yes
affirm
under
No
penalty of perjury that there is a construction
V
Lender's
Name:
APPLICATION CERTIFICATION
above
to
costs,
source
information is correct. I agree to comply with all city and county ordinances
enter upon the above mentioned property for inspection purposes. (We)
and expenses which may accrue against said City in consequence
regulations per the Cupertino Municipal Code, Section 9.18.
and state laws relating to building
agree to save indemnify and keep
of the granting of this permit. Additionally,
I certify that I have read this application and state that the
construction, and hereby authorize representatives of this city
harmless the City of Cupertino against liabilities, judgements,
the applicant understands and will comply with all non -point
Signature:
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.