BLD-2020-0642BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20635 NANCY CT Cupertino
APN: 359 15 025
PERMIT NO: BLD-2020-0642
OWNER'S NAME: PYLAPPAN SEEJO K AND KANNANKUNNI LEEYA BABY
OWNER'S PHONE: 9194126762
CONTRACTOR: VIVINT SOLAR DEVELOPER LLC, 1800 W ASHTON BLVD LEHI
CONTRACTOR PHONE:
DATE ISSUED 9/24/2020 10:48:47 AM
ISSUED BY: JASMINE ARCHBOLD
VALUATION: $14784
JOB DESCRIPTION
(2) (N) BATTERY ENERGY STORAGE SYSTEM; SUB -PANEL (120 AMP)
(N) 21 PANEL ROOF MOUNTED PV SYSTEM (6.720 KW);
LICENSED CONTRACTOR DECLARATION
C39 ROOFING
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
LICENSED
C46
LICENSED
EXP
06/30/2022
I hereby
force
I hereby
VIVINT SOLAR DEVELOPER LLC
CLASS:
SOLAR, C10 ELECTRICAL, B GENERAL BUILDING CONTRACTOR,
NO: 973756
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
laws of California. If, after making this
with such provisions or this permit shall be deemed
to self
Insurance,
which
certificate
three declarations:
-insure 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
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
under
the
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 requirements
the Cupertino Municipal Code, Chapter 9.12 and
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.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety
EPA LEAD -SAFE DISCLOSURE
for this project.
Firm Certification No:
project.
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this
Certified
v
CONSTRUCTION LENDING AGENCY
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 that there is
No
V
Lender's
Name:
APPLICATION CERTIFICATION
the
of this
-point
,
0
city
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
construction,
harmless
the
Signature:
.4
that I
the
applicant
I
have read this application and state that
and hereby authorize representatives
City of Cupertino against liabilities, judgements,
understands and will comply with all non
'
ir t i
4 1
k, dilik
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.