B-2017-0624CITY OF CUPERTINO BUILDING PERMIT
BUILDING.ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0624
19651 DRAKE DR CUPERTINO, CA 95014-2433 (316 32 029) SOLARCITY
OWNER'S NAME: CRAFF FERNANDO DANIEL AND VIRGINIA CARMEN T
OWNER'S PHONE: 408-203-0205
LICENSED CONTRACTOR'S DECLARATION
License Class C-10: C-46 Lie. #888104
Contractor SOLARCITY CORPORATION Date 12/31/2018
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.
CORPORATION
SAN MATEO, CA 94402
DATE ISSUED: 04/20/2017
PHONE NO: (650) 963-5100
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations: (N) 39 -PANEL ROOF MOUNTED PV SYSTEM (11.505 KW)
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. Sq. Ft Floor Area: Valuation: $22000.00
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
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, theacant understands and will comply with all non -point
source regulatio s r the Cu ertino Municipal Code, Section 9.18.
Signatures Date 4/20/2017
OWNER -BUTT DER DECLAR ATION
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)
z. 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:
r. 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 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.
3. 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
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.
Signature Date 4/20!2017
"N Number: Occupancy Type:
316 32 029
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Aygnde
g
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: 4/20/201
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, Ocons 2550 25533, and 25534.
Owner or authorized agent:
Date: 4/20/2017 CO
N 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
I understand my plans shall be used as public records.
Licensed
CUPERTINO
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING DIVISION -
10300 TORRE AVENUE - CUPERTINO, CA 98014-3255 AE
(408) 777-3228 - FAX (408) 777-3333 - bW1d!ng cl.cuoeriino.or€J
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PROJECT ADDRESS q/P
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OWNERNAM
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FAX
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CONTACT NAME Gerry Igtanloc
PH013E 650.-759-8042
I F-"wLgigtanloc@solarcity.com
STREET ADDRESS Foster City Blvd.
CITY, STATE, ZIPFoster City,CA,94404
FA"
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 9 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER. ❑ TENANT
CONTRACTORNAMESOIarCity Corp.
LICENSENUMBER888104
LICENSETYPE'C1O,C46
Bus. LIC #28844
COMPANYNAMESOIarCity Corp,.
E-MAILgigtanloc@solarcity.com
FAX
STREETADDRESS3055 Clearview Way
CITY, STATE, ZIP San Mateo, CA 94402
PHONE650-759-8042
ARCHITECTIFNGINEERNAME
LICENSENUMBER
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BUS. LIC #
COMPANYNAME
E-MAIL ¢
FAX
STREET ADDRESS'
CITY, STATE, ZIP
PHONE
use OF SFD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
PROJECT IN WILDLAND
URBAN IN'T'ERFACE AREA ❑ Yes I] No
PROJECT IN
FLOOD ZONE- ❑ Yes ❑ No
SOLAR PANELS
13ELECTRIC VEHICLE CHARGING STATION
SOLAR WATER HEATING
❑ OTHER:
FORSOLARPANELS. NUMBER OF PAN�ELSWNITS: 3 KILOWATTS (COMMERCIAL ONLY): l S®S
TOTAL VALUATION:
DESCRIPTION OF WORK
Install (3q ) rooftop mounted solar panels,(!j.51w) KW
00,
RE D BY
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 wis korrect. _I hi�vve read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to buildin onstruction``."�authonze r resentatives of Cupertino to enter the above-iiddenntif d property for inspection purposes.
Signature of Applicant(Agent: ! Date: t
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SUPPLEMENTAL INFORMATION REQUIRED
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OFFICE U'SS ONLY
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❑ MAJOR
PYApp 2011.doc revised 03/16/11
CUPERTINO
Address
SMOKE / CARBON MONOXIDE ALARMS O -,;�W-
O
WNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 FILE
(408) 777-3228 • FAX (408) 777-3333 • build ingCabcupertino.org 2
Permit No.
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 ever level of a dwellingunit includingbasements
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 R314 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
Owner (or Owner Agent's) Name:
�}-�i9-�� Si nature
Contractor Name:
Cj Signature .....
i
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with the terms and conditions of this statement
Date: F�1.. `.'
1. ....................Lic.#...................................... Date:
Smoke and COform.doc revised 03/18/14