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BLD-2020-1479BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10692 PINOLE CT Cupertino APN: 369 34 023 PERMIT NO: BLD-2020-1479 CONTRACTOR: SUNPOWER CORPORATION SYSTEMS, 1414 HARBOUR WAY S STE 1901 RICHMOND CONTRACTOR PHONE: DATE ISSUED 9/17/2020 9:36:55 AM ISSUED BY: KDUNBAR VALUATION: $15100 JOB DESCRIPTION MOUNTED PV SYSTEM (4.10 KW); (N) LOAD CENTER (100 AMP). (N) l0-PANEL ROOF LICENSED CONTRACTOR DECLARATION A GENERAL ENGINEERING CONTRACTOR of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full CONTRACTOR: LICENSED B GENERAL LICENSED EXP 02/28/2021 I hereby force I hereby SUNPOWER CORPORATION SYSTEMS CLASS: BUILDING CONTRACTOR, CI ELECTRICAL, C46 SOLAR, NO: 890895 DATE: affirm that I am licensed under the provisions and effect. affirm under penatiy of perjury one of the following I have and will maintain a certificate of consent for which this permit is issued. I have and will maintain Worker's Compensation I certify that in the performance of the work for which laws of California. If, after making this with such provisions or this permit shall be deemed three to self -insure Insurance, this certificate revoked. declarations: for Worker's Compensation, as provided for by Section 3700 of the Labor Co lie, 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 requirements 9.12 and under the Health Code, Chapter 6.95 of the California Health & Safety Code. Sections 25505, 25533. and 25534. I will maintain compliance I have read the hazardous materials the Cupertino Municipal Code, Chapter 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 EPA LEAD -SAFE DISCLOSURE will be responsible for this project. Firm Certification No: is required for this project. An EPA Lead -Safe Certified Renovator Firm Name: No EPA Lead -Safe Certified Firm Certified v CONSTRUCTION LENDING AGENCY that there is a construction 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 No V Lender's Name: APPLICATION CERTIFICATION and state that of liabilities, judgements, with all non the above this city -point 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 construction, and hereby harmless the City of the applicant understands Signature: read this application authorize representatives Cupertino against and will comply .