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B-2016-2954CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2954 19661 VICKSBURG DR CUPERTINO, CA 95014-3321 (369 08 017) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: DIAMOND DIANE M TRUSTEE OWNER'S PHONE: 408-252-5340 LICENSED CONTR A CTOR �S TT. nr ♦ u A TION avis License Class C10. C46 & B Lic. #888104 Contractor SOLARCITY CORPORATION Date 12/31/2016 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. hereby affirm under penalty of perjury one of the following two declarations: 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. r.W. 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. APPLICANT CERTIFICATION 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 relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the 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. Date 10/24/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. i, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 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. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's 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 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the 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. Signature Date 10/24/2016 DATE ISSUED: 10/24/2016 (650)963-5100 BUILDING PERMIT INFO: BLDG —ELECT _ PLUMB NIECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (1) 32 PANEL (3 ARRAYS) ROOF MOUNTED PV SYSTEM (8.48 kW) Sq. Ft Floor Area: I Valuation: $16000.00 APN Number: Occupancy Type; 369 08 017 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCCEE OR 180 DAYS FRCALLED INSPECTION. Issued by: Date: 10/2 RE -ROOFS: 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. Signature of Applicant: Date: 10/24/2016 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER, HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: 10/24/2016 - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION understand my plans shall be used as public records.. Licensed Professional' CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 + buildingO-cupertino.org U# PVApp_2011.doc ravised 03116111 1 (6- -Z-qsy PROJECT ADDRESS !NAME f L. OWNER_ �. ( PHONE_ r _ �L -s , E-MAIL STREET ADDRESS_ ��/ �^ cl G" ,. C �19gA�L FAX CONTACT NAME Gerry Igtanloc PHONE 650-759-8042 E MAB gigtanloc@solarcity.com STREET ADDRESS 391 Foster City Blvd. CITY, STATE, ZIP Foster City FAX ❑ OWNER ❑ OWNER -BUILDER. ❑ OWNER AGENT 12 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME SolarCity Corp. LICENSE NUMBER 888104 LICINSETYPE C 10 C46,B BUS. LIC# COMPANY NAME SolarCity Corp. E-MAIL gigtanloc@solarcity.com FAX STREET ADDRESS 3055 Clearview Way CITY, STATE; zIP San Mateo, CA 94402 PHONE 650-759-8042 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME- E-MAIL FAX STREET ADDRESS - CITY, STATE, ZIP PHONE USE OF M SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBANINTERFACEAREA ❑ Yes N No PROJECT IN FLOOD ZONE ❑ Yes KI NO SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: % Oct) DESCRIPTION OF WORK Install ( 2 �,) roof mounted solar panels. (,K.gg)KW. By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 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 lawg. relating to building construction. I thorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED �,:( V V 11/ "I � i� OFA .E.tISEONLY � � +EI2 TH)✓-COiJNTER ❑ Ess " � ,STANIIAxtI? ❑ LAROE: ❑' MAJOR PVApp_2011.doc ravised 03116111 1 WATER -CONSERVING PLUMBING F(XTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DWISION C UPERT040 -tglfl TORRE AV,,E-NUE-,CUPERTfNO,CA95014-3255 (408)777- '�218 FWJ4138) 777=33541® b01dinaC5wPeffino.or_Q Own -,r Nam et. Permit No,* JC 1, Addiess.1k ''1 C -1 ( 10 G, v" b! L Is your real property a registered historical site? El Yes iCivff Code Sections 11,01.1 through 11'01:8 do not apply. Skip the rest of the form and sign bottom of form. W' No 'Go to Question 2. 2. Does your real property have alicensed plumber cert iEying that, due to the aj;tr configuration of the property or its plumbing, installation of water -conserving plumbing fixtures " 1 is not technically -feasible? 0 Yes Civil Code Sections 1101.1 -through 1101.8 do not apply. 1:1 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the farm and sign bottom of form. CV No Go to Question 3. 3. Is water service permanently disconnected for your building? f El, Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest the he fortri and sign bottom of form. No --Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 0 No My teal property is built and available for use or occupancy after January'l, 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: My property 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), E I 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. On or before January 1, 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). E I 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, 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). upon corn, pieung and signing tuts uertiticate, please return it to the Building Division in order to final your building permit. SB40 7 2015. dac revised 0812 6115 I, 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 Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements. as indicated in the table on the following page. q or Owner Agent's Signature., caner ORA 1 z/ Datw-j upon corn, pieung and signing tuts uertiticate, please return it to the Building Division in order to final your building permit. SB40 7 2015. dac revised 0812 6115 n Envelope ID: 4A15CBCD-96CD-4945-8EB4-66778ADE4B2111 §. .u� t- r) 10 SMOKE ! CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228. FAX (408) 777-3333 • butiding cupertino.ora Address 19661 Vicksburg Drive Cupertino, CA 95014 Permit N©. b )n l 6 4 �91 �# of A IarmsSnieke: 8 Carbon Monoxide: 2. PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314, 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-farnily.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 Carron 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 bedroom(S) X X - On every level of a dwelling unit indudLnZ basements X X Within each sl� 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: hx dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existhig 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 mewls of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6,2. An electrical permit is required for alarms which roast be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarms) 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. 1 have read and agree to comply with the terms and conditions of This statement Owner (or Owner Agent's) Name; Docusiened by Diane Diamond rsi nater latMblaptDate. 10/12/20 L6 Contractor Name: DEsceeEDe6 Sinature ..................... I........ ... ..:......... .Ltc.#........ .. ....Date:.:. .......... S+noke and COfvrrn.doc revised 03118114