BLD-2020-1305BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10099 RIDGEWAY DR Cupertino
APN: 342 41 022
PERMIT NO: BLD-2020-1305
CONTRACTOR: TESLA ENERGY OPERATIONS INC, 901 PAGE AVE FREMONT
CONTRACTOR PHONE:
DATE ISSUED 8/20/2020 4:12:44 PM
ISSUED BY: KDUNBAR
VALUATION: $10000
JOB DESCRIPTION
PV SYSTEM (4.08 kW) W/13.5 ENERGY STORAGE SYSTEM; (N) LOAD CENTER (125 AMP)
(N) 12-PANEL ROOF MOUNTED
LICENSED CONTRACTOR DECLARATION
0 ELECTRICAL, C39 ROOFING, C36 PLUMBING
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
LICENSED
LICENSED
EXP
I hereby
force
I hereby
TESLA ENERGY OPERATIONS
CLASS: C46 SOLAR, B GENERAL
NO: 888104
DATE: 12/31/2020
affirm that I am licensed
and effect.
affirm under penatiy
I have and will maintain
for which this permit is issued.
I have and will maintain
I certify that in the performance
laws of California.
with such provisions or
INC
BUILDING CONTRACTOR, Cl
under the provisions of Chapter
of perjury one of the following three
a certificate of consent to self -insure
Worker's Compensation Insurance,
of the work for which this
If, after making this certificate
this permit shall be deemed revoked.
declarations:
for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's
of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under
the Cupertino Municipal Code, Chapter 9.12 and the Health
V
with
equipment
Municipal
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
Sections 25505, 25533, and 25534.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
EPA LEAD -SAFE DISCLOSURE
Renovator will be responsible for this project.
Firm Certification No:
Firm is required for this project.
An EPA Lead -Safe Certified
Firm Name:
No EPA Lead -Safe Certified
Certified
v
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address:
I hereby
Yes
affirm
under penalty of perjury that there is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
and state that the above
representatives of this city
against liabilities, judgements,
will comply with all non -point
.