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10090187 CITY OF CUPERTI vO BUILDING PERMIT BUILDING ADDRESS: 1150 STAFFORD DR CONTRACTOR:SOLARCITY PERMIT NO: 10090187 OWNER'S NAME: RAJA VENKATESH 393 VINTAGE PARK DR STE 140 DATE ISSUED:09/20/2010 'WNER'S PHONE: 4083143320 FOSTER CITY,CA 94404 PHONE NO:(650)638-1028 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class C41&,C y?}-i3 Lic.# i C>`l PANEL UPGRADE TO 125 AMP 11 Contractor � , S��L4 Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36207006.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relatir g WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued by: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date 2 U CL> All roofs shall be inspected prior to any roofing material being installed.If a roof is _ installed without first obtaining an inspection,I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensatic n, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors toHAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,,2 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: f Date: "�-Z6 permit is issued. — J I certify that in the performance of the work for which this permit is issued,I shal not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I in ist I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relat ng to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, ;osts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source r ulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. f/l Signature /` Date ,� CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Bl<: Lot: APN . . . . . . . . : 36207006 . 00 DATE ISSUED. . . . . . . : 09/20/2010 RECEIPT #. . . . . . . . . BS000011505 REFERENCE ID # . . . 10090187 SITE ADDRESS . . . . . : 1150 STAFFORD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER RAJA VENKATESH ADDRESS 1150 STAFFORD DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4912 RECEIVED FROM . . . . : SOLARCITY CONTRACTOR . . . . . . . : LYNDON RIVE LIC # 28844 COMPANY . . . . . . . . . . : SOLARCITY ADDRESS 393 VINTAGE PARK DR STE 140 CITY/STATE/ZIP . . . : FOSTER CITY, CA 94404 TELEPHONE . . . . . . . . : (650) 638-1028 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 2, 000 .00 1. 00 0 .00 1 . 00 0. 00 1EPERMITFE FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 . 00 1ERT<200 UNITS 1 . 00 42 . 00 0 . 00 42 . 00 0.00 1TRAVDOC FLAT RATE 1 .00 42 . 00 0 .00 42 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 127. 00 0 . 00 127 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 127. 00 111024 --------------- TOTAL RECEIPT 127. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 1150 Stafford Dr. DATE: 09/20/2010 REVIEWED BY: jsg APN: BP#: "VALUATION: 1$2,000 *PERMIT TYPE: Electrical Permit PLY LN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex ,1t PENTAMATION 1REAP2 USE: PERMIT TYPE: WORK SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1 ERT<200 125 Amps $42 TOTALS: $42.00 1.1c,tJ 1, o-1("k,;,1 ft PJ oO, 1'hw t h,f"� Elec.Plan Check 0.0 hrs $0.00 i" t'c >ril Far: Elec.Permit Fee: IEPERMIT h.rvl> 01 c'r P/ _„?;/j,; Other Elec.Insp. 0.0 1 hrs L$42.00 I- J'A" /",oI'.'zimh h,elz I'c" 111c"c_My, Po, NOTE. Thesefees are based on the preliminaty in ormation,available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 09-051 E('. /7-7!10) FEE QTY/FEE MISC ITEMS Phni C hec; 1 c c: slip /1 PC:"1',v PME Plan Check: $0.00 Pet�Jnit 1�<ze: PME Unit Fee: $42.00 PME Permit Fee: $42.00 t'(IMS IW[1017 TCJ.rF-1 I ollslicr1112c Work Without Permit? 0 Yes E) No $0.00 1}1L71Zt11)7�r l`t'C':).` Travel Documentation Fee: ITRA VDOC $42.00 A Strom Motion Fee: $0.50 Select an Administrative Item Bld-Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: r $127.50 $0.00 TOTAL FEE: $127.50 Revised: 9/14/2010 .In oor Qir Quality an Finishes I.Use Lov,,/No-VbC Paint 2.Use Low VOC,Water-Based Wood Finishes 1 iAOJHealth pts Y=Yes 3.Use LOW ND VOC Adhesives 2 IAQ/Heaithis D P Y=Yes 4.Use Salvaged Materials for Interior Finishes 3 IAO/HealthY=Y� is D P D 5.Use Engineered Sheet Goods with no added Urea 3 Resource pts y=yes 0 Formaldehyde 6.Use Exterior Grade PIYVvood for Interior Uses 6 IAQ/Health pts y=yes 7.Seal 11AQ/Health is 0 all Er,�o':eel I'.ariiolebaard Dr MDF P y-yam 0 S.Use FSC Certified Materials for Interior Finish — 4 IA4IHealth is = es 9.Use Finger-Jointed or Recycled-Content Trim 4 Resource pts y=yeS D 10.Install Whole House Vacuum System 1 Resource pts y=yes D 3 IAQ/Health pts y=yes D N.Flooring , ! D 1.Select FSC Certified Wood Flooring 2.Use Flocify Renewable f=looring Materials 3 Resource pts y=yeS D 3.Use Recycled Content Ceramic Tiles 1 Resource pts y=yeS D 4.Install Natural Linoleum in Place of Vinyl 4 Resource pts y=yes D 5.Use Exposed Concrete as Finished Floor 5 IAQ/Health pts y=yes Resource 6.Install Recycled Content Carpet with Low VOCs pts Y=yes 0 0 Resource pts y=yes D Total Points Available: 140 130 Total Points Pro'ect Received: G:data/prDWgreenbL ildingguidelineslramodelers/greenp6intsfina1212P4prDlectedAs CITY OF CUPERTINO Fry aF CUPS TING GENERAIj BUILDING PERMIT APPLICATION FORM APN # Date: Building Address: Mailing Address (if different from building address): Are Hazardous Materials being used as part of this; project? Yes No HOA: (Exterior work only) Yes ❑ No ❑ If yes, provide letter from HOA Owner's Name: Phone#: 4o -S Contract r•_ Phone: (6�� c;- ��.�` Fax: Contractor License#: Cupertino Business License#: 2et--41-1 Contact: _ Phone: 4>S e; _2? - 3 2 c :� �r��. Fax: Residential Commercial Job Description: (2S A Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ MIIUV-A ❑ II/VI B, IV-HT,V-:3 3 Valuation: Square Footage: "n Project Size: Express ❑ Standard ❑ Large Major ❑ Green Building: Please complete relevant portion of the Green Bu2ding/LEED Checklist& attach it to the application or if applicablo, include in plan set & the sheet index. Points Achieved: For help, contact Build it Green at www.buildj=!en.or Revised 07/14/09