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B-2016-3027
CITY OF CUPERTINO BUILDING PERMIT CONTRACTOR: PERMIT NO:B-2016-3027 05BUILDING DMANZANIRTA CT CUPERTINO,CA 95014-6579(342 61 024) SOLARCITY CORPORATION SAN MATEO,CA 94402 s DATE ISSUED:11/03/2016 OWNER'S NAME: YEGNASHANKAItAN VISVAMOHAN TRUSTEE OWNER'S PHONE:408-476-2417 1PHONE NO:(650)963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10:C46:B Lic.#888104 Contractor SOLARCITY CORPORATION Date 12/31/2016 —X BLDG —ELECT _PLUMB ' provisionsChapter (commencing X RESIDENTIAL_COMMERCIAL I herebyaffirm that I am licensed under the of 9 commencin with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: 24-PANELPV SYSTEM(7.56 KW) I hereby affirm under penalty of perjury one of the following two declarations: ROOF MOUNTED t. 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,�.i I have and will maintain Worker's Compensation Insurance,as provided for by r Lection 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$14000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for 342 61 024 inspection purposes. (We)agree to save indemnify and keep harmless the 1 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 granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulationsperthe Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. %....,. Signature Date 11/3/2016 Issued by:AbbyAyende c.,f Date: 11/03/2016 OWNER-BUILDER DECLARATION , I hereby affirm that I am exempt from the Contractor's License 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 i. 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:11/3/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. 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 Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the 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, ctions 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall ,.v li APPLICANT CERTIFICATION {%Date:Owner1 authorized agent: be deemed revoked. 3/2016 correct.I agree to comply with all city and county ordinances and state laws of worko CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby s firm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city ;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. I understand my plans shall be used as public records. Signature Date 11/3/2016 Licensed 9 Professional 6--iot62-302-3 \\ /fALTERNATIVE ENERGY PERMIT APPLICATION AE i COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ,, 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 �s° ss (408)777-3228•FAX(408)777-3333•buildinq(a�cupbrtino.org CUPERTINO PROJECT ADDRESS ® APN# ii in Turn 1-1ivL6 'S141 ct C1 OW�N^ERNLA�MrE-, 4 ,r,/ a �y �^ta�/� ` Bg,,['e A !4346 i'f 8V Cee K)4-S7 y1-1"cV�-2 PHONE it - '- '(�9 �f.�.�-- E-MAILE Q1 4►'�--:o ' ��..-: J `L..�- STREET ADDRESS p CITY, STAGE,ZIP ® q FAX Y (,1 �"CA' tc, !'( i H-7(S ' `2.17 ai 4t:)__ C l O t 4-d' CONTACT NAME Gerry Igtanloc PHONE 650-7'59-8042 E-MAIL ggtanloc@solarcity.com STREET ADDRESS. 391 Foster City Blvd. CITY,STATE,ZIP Foster City FAX ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT a CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME SolarCi CO LICENSE NUMBER 888104 _ LICENSE TYPE BUS.LICE ty rp' C10C46,B 2 aSq-(4. Le COMPANY NAMESolarCity Corp. E-MAIL gigtanloc@solarcity.com FAX STREET ADDRESS 3055 C1earview Way CITY,STATE,ZIP San,Mateo,CA 94402 PHONE 650-759-8042. ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC E COMPANY NAME E-MAIL FAX. STREET ADDRESS CITY,STATE,ZIP PHONE USE OF nil SFD SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND - PROJECT IN STRUCTURE: 0 Commercial URBAN INTERFACE AREA ❑ Yes No FLOOD ZONE 0 Yes No Q SOLAR PANELS 0 ELECTRIC VEHICLE CHARGING STATION D SOLAR WATER HEATING El OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): - TOTAL VALUATION1 t d �� c tIo DESCRIPTION OF WORK Install(Zi )roof mounted.solar panels. (5L, .)K V V7. RECEIVEDB 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 complywith all applicable local Signature oaApplicant/Agent:alaw p Pe to enter the above-identified propertyffor inspection purposes. Date: © ( Z 6 f it`e- ordinances and state laws relatingto buildm construction. authorize re resentatives of Cu rtmo � SUPPLEMENTAL INFORMATION REQUIRED t7EFICEtiSE<TIYLY w C7 OVER-THE-COUNTER 0 EXPRESS d s2A D&m a 0-LARGE, 0 MAJOR PVApp_2011,doc revised 03/16/11 DocuSign Envelope ID:2D51701 E-CD45-49F6-8BBC-CEC1 BDC6OECF ❑ i . I ❑ ❑ • ,...t. 1.i/ SMOKE/ CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE k.' ';.fsJ` COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPEttTtt•LO 10300 TORRE AVENUE•CUPERTINO,CA 950144255 (408)777-3228•FAX(408)777-3333•buildings)cuaertlno.orq Permit No. c3,--2-61-1- '3O Q-? Address 10546 Manzanita Court Cupertino, CA 95014 (#of Alarms(Snoke-.) 7 (Carbon Monoxide" 1 i;ililitrk CANNOT RE FINALED:ANia COMPLETW UNTIL THIS CERTIFICATE ntAs tE gr NlD : TLJRN:n aTO` Bibi �TGDW SIGN ; 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 CRC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. 1 1 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 vicinityofthe X X bedrooxx►(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 urning appliances and that do not-have an attached garage. Carlton 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:rn dwelling units with no commercial power supply,alarm(s)maybe 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 R314 and CBC Sections 907.2.11.4 and 420.6.2.An elecia-ical 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)refer raced'Iabove has/have been installed in accordance with the manufacturer's instructions and in compliance wih 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 cornpj r with the terms and conditions of this statement ' Owner(or Owner Agent's)Name: r cosigned by: Visvamohan Yegnashankaran (stg;,atilio_.. �/iSw b t atn, thttioduttatirtUA, rn �1 o/20/2o_6 Contractor Name: "---E98538BEB4D841E--- Signature Licit Date: Smoke and COform.doc revised 03/18/14 DocuSign Envelope ID:2D51701E-CD45-49F6-8BBC-CEC1BDC6OECF ® ' / WATER-CONSERVING PLUMBING FIXTURES U.• ❑ OWNER CERTIFICATE OF COMPLIANCE „ tis COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CUPERTIN 10300 TORRE AVENUE•CUPERTmo,CA 95014-3255 (408)777-3228-FAX(408)777-3333•buildinata7cunertino.org OwnerNaane Visvamohan Yegnashankaran6,1_6/6 36'1,7 Permit No. Address 10546 Manzanita Ct, Cupertino, CA 95014, US (SANTA CLARA County) PERMIT CANNOT BE 11NALED ANI1 COMPLETED I}NTII THIS:CERTIFICATE �BEE Slt' `D,.�RETURNED TO'1H UILDI(NC!DIYISIrON : Please refer to the attached California Civil Code Sections 1101.1-1101,8 which are part of this Certification form. - 1. Is your real property a registered historical she? O Yes Civil Code Sections 1101.1 through 110L8 do not apply. Sign below and skip the rest of the form. ,—DocuSigned by: Owner'Signature: Visyw obatGt, itiitA,a.Su,u aVatA, Date: 10/20/2016 ®' No Go to Question 2. " t—E98538BEB4D841 E... 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? O Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. --DocuSigrted by: ,..,/ Owner'Signature: VtSu4tatet,atrt, gtlrt1,St.A.Lt, lir LVn, Date: 10/20/2016 t No (lo to Question 3, y,E98538BEB4D841E--. _ -_" 3. Is water service permanently disconnected for your building? O Yes Civil Code Sections 1101.1 through 1101.8 do.not apply. Sign below and skip the rest of the form. ,—DocuSigned by:. Owner'Signature: t t Date: 10/20/2016 l'No Go to Question 4. tlSv�awt6 ,attAf 1n atStatAuVYh IA, --E98518BEB4D841 E...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. Sign below and skip the rest of the form. ,—DocuSigoed by: Owner'Signature: USu vitiot uu,tit/v.as(R ai4,0ot, Date: 10/20/2016 Yes \__E9B53BBEB4D84tE..- El 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. Refer to the attached. 0 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 befoie January 1, 2017,all non-compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures(regardless of whether property undergoes alterations or improvements). My property is a riiultifamilyresidential 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 ofwhetherproperty undergoes alterations or improvements). L7 Myproperty 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. 3B407 2014 dot revised 03/18114