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B-2016-2825 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2825 10698 LARRY WAY CUPERTINO,CA 95014-2057(316 02 036) CLEAN SOLAR INC SAN JOSE,CA 95112 OWNER'S NAME: EANEFF CHARLES S JR AND LORRAINE D TRUSTEE DATE ISSUED:09/28/2016 OWNER'S PHONE:408-771-5015 PHONE NO:(408)217-8876 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10&C-46 Lic.#910849 Contractor CLEAN SOLAR INC Date 02128/2018 X BLDG ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations: (N)13 PANEL ROOF MOUNTED PV SYSTEM(8.06 kVA 1. 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. 2. ,'r 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 permit is issued. Sq.Ft Floor Area: Valuation:$31467.00 APPLICANT CERIM ATION 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 APN Number; Occupancy Type: and state laws relating to building construction,and hereby authorize 316 02 036 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the gra ting this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will.comply with ail ll non-point source regulations per the Cupertino Municipal Code,S ction 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature! tA✓{/il D ate 09/28/2016 Issued by:MELISSA Date:09/28/2016 I hereby affirm that I am exempt from the Contractor's Lense Law for one of the RE-ROOFS:_ following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:09/28/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 1 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the, material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall y� tC(c% ' be deemed revoked. Owner or authorized agen -- APPLICANT CERTIFICATION Date:09/28/2016 y I certify that I have read this application and state that the above information is CONSTRUCTIONEING correct.I agree to comply with all city and county ordinances and state laws 1 hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec..3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 09/28/2016 Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C'UPERTINO (408)777-3228 FAX(408)777-3333•building(ftupertino.org PROJECT ADDRESS Q f / 0 A �' /} Z-0 14 1i/ tW�311�4b IViv APN# "Le�1 OWNER NAME V %VAI I� J 7 �1 V6 1V PHO STREET ADDRESS CITY,STATE,ZIP i�\ p y��a'�(!� FAX CONTACT NAME (j/ [mayONE E-MAIL �I j IL STREET ADDRESS Y,STATE, I � E4 ( J 0111 bra f �CITv ❑OWNER ❑ owNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 6IN,rT^�RACTOR AGENT 11 ARCHITECT ❑ENGINEER ❑ DEVELOPER C� TENANT CONTRACTOR NA1 f LICENSE NUMBER r �� °p 1. LICEN01 BUS.LIC# '3 1 3 61 Cjf'0 COMPANY NAME _ E-MAIL nay ` F f/, p y t'I l ; IPSTREET ADDRESS 82 CITY,STATEC P ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL — FAX STREET ADDRESS Y CITY,STATE,ZIP PHONE USE OF SFD Of Duplex ❑ Multi-FamilyPROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial TTJR13AN INTERFACE AREA ❑ Yes �No FLOOD ZONE ❑ Yes Y No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION I ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLARPANELS. NUMBER OF PANELS/UNITS: 113 KILOWATTS(COMMERCIAL ONLY): (Zy p TOTAL VALUATIO j__—J V)DESCRIPTION OF WORK � G=.�!'0� � p�JI, 13 �Z I D BY By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on e prope ner s e a f. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to mg co traction. I autho• e representatives of Cupertino to enter the above-iden fi d ro erty for inspection purposes. Signature of Apphcant/Agent: Date: SUPPLEMENTAL INIORMA N UIRED oFFIcu5EornY. Cl1e� I C �YYL .,. RT11E-COUNTER STANDARD � � ❑ L�iRGz„.,,f ,�� 15IAJOR S PVApp_2011.doc revised 03116111 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE FILE COMMUNITY DEVELOPMENT DEPARTMENT.BUILDING DIVIS ION CUPERTINO 10300 TORRE AVENUE m CUPERTINO,DA 55014-3:255 (408)777-3228 m FAX X408)777-.3333 m buildinaftcupertino ora Owner NamI101._-,,,nom F all—JE Permit N9,41111 .151-1016-2125 Address 1 O 6 1��,�,w_ �,. �l �a 1 ' _`20 5`7 I. Is your real property a registered historical site? T❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. kr No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? Yes Civil Code Sections 1101.1 through 1101.8 do not apply. El The licensed plumber's certification has been provided to the Building Division, Skip the rest of the form and sign bottom of form. Ey N No Go to Question 3. 3. Is water service permanently disconnected for your building? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. l No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: Myproperty is a single family residential real property. See Civil Code Section 1101.4. On and after January 1,.2014,building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). O My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after.January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with;water-conserving plumbing fixtures. a On or before January I,2019,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1 2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1, 2049,, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements).. 1,as the owner or.owner's agent of this property,certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8,the current California Plumbing,Code and California Green Building Standard's Code,and manufacturer's installation requirements,,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the fallowing page. Owner or Owner Agents Slgnaturm Date: ; 10-5-1 . Upon completing and signing this Cei-tifcate,please return it to the Building Division in order to final.your,building permit. SB4072015.d6c revised 08126/15 SMOKE / CARSON !MONOXIDE ALARMS 0 OWNER CERTIFICATE OF COMPLIANCE FILE OMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION f� r�6 �J�(� CUPERTIIN© 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 (408)777-3228 FAX(408)777-3333• building(Qcuoertino.org; L 1, �� Permit-No. �res� �'J�#of Ala-rms Smok�ie: Carbon Monoxide:? 2-• PERMiT CANNOT B�EFI7NALED AND COMPLETED UNTIL.�THIS CERTIFFICATE . �EE � „di.`.31�iC �I �TH ,Pii�iLV� i� rll{�N RLTi7]�RI�t, r ; PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke,Alarms and Carbon Monoxide alarms. When the valuation of additions,alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling units with no commercial power supply, alarm(s)may be solely battery operated. In existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl space.Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been installed in accordance with the manufacturer's'Instructions and in compliance With the California Building and California Residential Codes.The alarms have been tested and are operational,as of the date signed below. I have read and agree to comply with the s and conditions of this statement Q r(oiOwnerAgenfs}Nafne Si nafu stet ......... ....:.❑ fa e��lI1(!J C6_hFacfor_Name: \4�4.- ......t© 9 9 - 1 C? 1 r Si�afure .,LrG•#.. ......... {Dabs ............. ;Smoke and CO form.doc revised 03/18/14