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08020100
CITY OF CUPERTINO � BUILDING DIVISION PERMIT $cCUITI2ACTQR+IAF© TTQ'..N" �: "07 NG ADDRESS: PERMITNO. 1371 ASTER LN COBALT POWER SYSTEMS, INC 08020100 NER'S NAME. FERMrr MSUB DATE SARAH & ROBERT ERICKSON 2444 OLD MIDDLEFIELD WAY 02/25/2008 PHONE: OTD a SANITARY NO. CONTROL NO. (650) 938-9574 ARCHI EC(ENGINEER: BUILDING PERMIT INFO -BLDG ELECT PLUMB MECH 0 0 0 0 300 LICENSED CON RACTOWS DECLARATION Job Description 1 hereby affirm that I am 1'icmuud under provisions of Chapter 9(commencing p Z wmNSeries 70M)ofD1,tdW3oftheRmi.andProlessimutpCode,wedmylicense is INSTALL ROOF MOUNTED PHOTOVOLTAIC SOLAR POWER (NO >=Z inkenl force and offer.G7 0 �.g 2 0(v / cmntrada BATTERY BACKUP) —PAINT PANEL FRAMING TO MATCH ROOF eq�q ARCHf1ECTS DECLARATIO W U 1 undenu d my plans shall M used u public meoNa COLOR. 6 50�n Licensed Pmressianal gors Oat I am exempt R DECLARATION 9 0 0 I hereby.(Sere s,I I. exempts an Pr Canuues Co :Any c Law for the E00 e o following tenon. anal,b 7113 L$a Business and pn(de ooli Cole;Any city of county e .� which requires a permt n constroeL titer.impmve,demolish,n mpnir any structure Z P„' prier n its issuance,also mated.the applicant for uch Permit to file a signed atatemen 40 Thal he lalicensed pursuant l0the provisions ofthe Conl mr'sLicamaeLaw(Chapnr9 Sq.Ft.Floor Area Valuation 3 (commencing with Section 7")of Division 3 of the Busimocand Professions Code)or $2 9 5 31 .. that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant far a permit subjects the applicant in a civil penalty of Number Occas ane T e nor man thaIt.n w hundred dollars(53001. 36617111:tl U' � p y yp 1,uownerditheproperty.carmyemployeeswithwagesututrsoleeampe dan, will do Ilcwark,and theskuctuhe is notutended oronamed forsale(Sec.M M.Buainess and Professions Cade:The Conoacnr`a LlcenM Law does not apply to an caner of Required Inspections property who builds or improves thereon,and who does such wmlk hhnsel f m though his awnemployees,provided Oatsuchimpmwmansarenotintend woRem forsda.If. however,the building orimProvement is sold within arc year of oampladon.the owesr- builder will have the burden of proving that M did ant Mid or improve for purpose of sale.). 0 1.u owner of the property,am exclusively competing with licensed cmnoactors in contract the project(Sec.7046,Business and Professions Code:)The ConramaYs Li- ceva law done not apply Is,an owner of property who builds or improves thereon,ad. — whoconoacufor such pnjeeu with a contractor(s)licensed pursuant to is Conuactoes Lim.Law. ❑I am caterm under Su. ,B k P C for this moon nu Data WORKER'S COMPENSATION DECLARATION 1 hereby aRrm under Pointy of pujury one of the following declarsolor : ❑Ihavatnd will mainuina Ccrtifmcauof Conunttoulf-ream ear Worker`&Compere Milan,an provided her by Sutton 3700 of the labor Code.for the performance of the work for which this permit is issued. 1 have and will mainum Worker's Compensation lmmtance.u required by Section 3700 of the Labor Cods,for the performance of the work for which this permit is issued. ' My Works&Compeesatian Wunnce earriu end Policy numbs art: Csrtiert / / .ral Policy No.:611/C OCfJ64700 CERTIFICA OFEKEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sedan need notMcompleted if the permit Isformhumbed dollars($10) or lens) 1 cerdfy the,n to parfmmance of the work for which this Permit is issued.l shall mol employ any person in any manner so as to become subject to the WorkerY Compensation Laws of Califomis Data Applicant NOTICE TO APPUCANM..If,after making this Certificates of Exemption.you should become subject m the Worker`s Compensation provisions of the UWr Code,you must . .J O forthwith comply with such provisions m this permit shall bo diamond revalued. z CONSfRUMON LENDING AGENCY I hereby affirm thatthem is a construction lending agency for the Pmrfurmanca of the work for which this permit is issuod(Sec.3097.Civ.C.) WM Q Lender's Name D Z lender's Address fJ Q 1 curtly that I haw need this application and atste that the above Information Is w correct.I agree In comply with all city and county ordinaneG and sow lawn Riadng in .�U building construction.and hereby authadxe representatives of this city to enter upon the W above-menuond pnPerty for Inspection purposes (We)agree to save,indemnify and keep himtless the City of Cupertino against UmV gn liabilities judgments.cause;and expenses which may In any way accrue against said City Z in consequence of the granting or this permit. APPLICANT UNDERSTANDS AND Wr�L COMPLY WITH ALL NON-POINT Issued by: SODate l{� RE LATIONS. ^ /�s/O� 1�V G(/ Re-roofs �J Signuum of pplicanoCoDataHAZARDOARDO US MATERIALS DISCLOSURE Type of Roof Will the applicant no Faure building oecupanumre car handle Health and u defined io the Cupertino Municipal Caere.Chapter 9.13,and the Health and Safety Section 25332(e)T ❑Yes No All roofs shall be inspected prior to any roofing material being installed. Will the applicant of future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove malt M.M.us oar cmisminanu as JeOncd by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yue KN. I have mad the heraNnus materials requirements under Chapter 6.95 of the Califon nia Health&SafcryCode,Schon 25505,25533 VW 25534.1 understand that if the building Jove.1'mot hew a unanL that It is my responsibility te noury,the mcupan,of the ngni,emna hmwlbemglgdarninstance rac �YSryPvmp,� Signature of Applicant Date OO nes r�wanthorsedagent / Dam All roof coverings to be Class"B"or better !m