08020168 PCITY OF CUPERTINO :� -�h'S''.' 'a'.T.e!.a^�'f>lY 7,
BUILDING
5 '
BUILDING DIVISION PERMIT �,,C,U". 1RAC�°�t'CZR II`,aRMAT,IT!T ,
PERMIT NO.
Bu1LI,z�rd��gDRROBINDELL WAY SOLARCITY 08020168
NER'S NAME: PERMIT SUE DATE
HUI PAUL W AND EVELYN L 393 VINTAGE PARK DR STE 140 03/24/2008
PHONE: SANITARY NO. CONTROL NO.
(650) 638-1028
ARCHMICTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
3 o p LICENSED CONTRACTORS DECLARATION
rd g I catch,Nirm dead1 w raved under provision,of Chimer9(com.cnaing Job Description
with Section 70n)ofDivraim 3 of Ute Buslrcs and Proresdov^ 'Co,dand,amy licenses 2 .4KW ROOF FLUSH MOUNT PHOTOVOLTAIC—PAINT
n m k full for aM cfra t. $$$l
� ? ucnmoomLie.,— e.• FLASHING
DM
DECLARATION 1 TO MATCH ROOF COLOR PER PLANNING.
e'
y I understand my plan Nal On used as public mmrds
a esti Licensed Pmfessianal
5 OWNER-BUILDER DECLARATION
Con cur
C0 S I hereby o(Em Net 1 1. uusin from the Covns Co Electra ty O for Be
00 following Ronstr Business and Professions CWr:Any crty OT County
S$lei which tequima•permit re cores de, alien Improve.demolish,t or e a sig aY structure
ZS^ prior OAL he its issuance.Maninquire theapprmt tforsuch he Conpcmrt mftlea LawU,ukmcm
xx< (commis elkmucd pumtion to On of Division
of the Conounets,uttnwlcw(Chwmr9 Sq.Ft.Floor Area Valuation
1-g OnImenHammin Section?andthD it frmUm Butlnm.don.My
Code)or $13000
On io k exempt tbertrmm and or Erik it she alleged assumption.Any rimulm or
Section1031.5n any
redivmtrs(apermit subjects the.pplkatm,rnil pemlty or Number Occupancy Type
not marc than row bormita dlsn(f300). � 3 6223 005!V�
❑L u awtak.Ute PiuPmY,or is al iota sat with pees tktr role cempesntuon,
wedcothe tions andChm-The Ctmkrotroundeda Law
ed deformic pply W a4,Business
and er ywho Code:The Contrdlnes Umnse his dm mat appy if rt rdurandough it Required IflapeCt100S
We enywho bollds thiel d avers tkeogaements am nouchwvkhimseVor through bit
awns ,0.building
pssuch ve.antis tmesuart rotImr dical Of
forala...
however,Ne killing u hdpmwmainis that
within oro year of romple for the mamer.
or
.I..). will kw W burden of Proving Nn k did not bugs or Improve far purpose of
0 1.as Owner of the progeny.am adlusvely contracting MN licensed mntrdton m
conduct the project(Sec 7044.Business and Pm(radans Cade)Th Conuacur,U.
mise Law does not apply to an owxr of property who Wild,or improvers themon,and.
who commas far such projects with a conudmr(.)Ilcensed pummmt m the Chordates
Ucerse Law.
❑I am exempt under See .B d P C In,this woe
Data
WORKERS COMPENSATION DECLARATION
1 himby af0m under Family of p apary ane of Uta fallowing dclarsaon,:
❑Ikw arta will redbyn•CenrOe,u of the U,btaCode,furc ror WOrM,ce of the
main, r provided for by Ss issu 7700 0(the arbor,Cade,for the performance a(the
doh for which this permit is s,.d.
111 1 haw and will..Intel.Workees Compev,Uan Insurance,u inquired by Section
of the Labor Cad,for the palomace of the work far which this permit ran Issued.
My Wvkees Compuuaar,,U}1}O.n,Inand.carrier and Policy number art: —�yy
Carrier. mfg(C?rJI ICr Policy No.:C0�r'1 0q1a/
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(IMa,ecdm oath s kcomplemd iron pemth is foram hundred corn($100)
or kat)
1 miry that in the pafamam m On work for which Ol.pamit is Woodl mill rot
employ any period in my Warner m�taco es bb et to Unwohus'Compensation
Laws arc lira Qafu,�l aF—U7S
Applicant L' l n
NOTICE TO APPLICANT.If.after making this Certificate of Exemption,yin should
become subject u than Workari Compcnution provision,of line labor Cede.you main
.J O forthwith comply with such provisions or this permit still k mm
deeed uted. .
,z.,y CONSTRUCTION LENDING AGENCY
Gi t7 Ute work fur which Iscraby
at Nem 1.•cmdntalm kndugagency for the paparfums.fumnof
permit is Wood(Sec.3097,Civ.C.)
Ip7 Q I-andos Nam
Z Landes Address
U O I century Wt I haw,rut his mpliculon and soon Use the.how information Is
is,^'! carr.I am an comply with LI city uM county Ordinance W sum swat minting an
.O Wilding cooummron,and herby solitaire ieprcamuaws of this city to as upon the
4i7 above-mendonce property for inspection POPOWL
C (We)agree to use.indemnify and keep harmless On City of Cupertino!Inned
y liabilities.juegmems,costs and expense,which may In my way acrnu.g.inst mrd Ny
t„)7 in consequence of the granting of this limit.
t1• APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
.�.Ali)MP Y)Yl o3-04-0g Re-roofs
Si uurt orApplimnVCtnudter Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII On applicant or futon building omupaa Mrc whandle haardous material
dented by the Cupertino Municipal Cade,Chapter 9.11 and the Health marl Safety
sectrtn 25532(.)7
[:]Y. No
All roofs shall be inspected prior to any roofing material being installed.
(�
Will the applinnt or future building Occupant use equipment or denim which If a roof is installed without first obtaining an inspection,I agree to remove
emit hursrcoW Orr cmtamiemu as deftdd by On Bay Ma Air Quality Mamgomam all new materials for inspection.
District?
0Yes No
I have mad the huamous materials requirements under Chapter 6.95 ofthe Califon
ora Ha an h Safety Code,Section 25505,25533 and 75534.1 undenund On if the building
does not currently kw,unset.thin It's my responsibility 0 mdfy the accupaa of On
7Nn;;rcyui menu whkh monk tpriormissuutcc of a Coram¢of Occupancy. Signature of Applicant Date
op Zan n n co-a� cfi All roof coverings to be Class'W'or better
Owner ormthmided.gens Data