08030153 (2) CITY OF CUPERTINO ..�tusa•,:.,_..>:.f�>;
BUILDING DIVISION PERMIT "tO TRAGTOR-I�NEORMATION
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PERMR N0.
IBUIL`TW1"'XCACIA WAY LOT 3 HORIZON ENERGY SYSTEMS 08030153
(OWNER'S NAME: PERMTf hrUBDATE
SHANAHAN LIM P 0 BOX 320612 04/03/2008
r ONE: SANITARY NO. CONTROL NO.
(408) 395-9060
HRECDFNGINEER: BUILDING PERMR INFO
BLDG ELECT PLUMB MECH
ups LICENSED CONTRACTOR'S DECLARATION
x 1 hcmby affirm Not 1 am Ikeved under pmvisiom of Chapter 9(mmmcncing Job Description
< with Section 701111)ofDivision3OrionBoostsandProfession,Cod.,aMmyties.I. PV(SOLAR ELECTRIC) GRID-TIE SYSTEM, FLUSH MNTD
n mfallfameaneerrx HORIZON ENERGY SYSTEM PD RENEWAL 3/26/8 $110 . 00
ucenw Cl • Lbi.x jP2� g29
Or, Dam Continuator U,,.:.swm,.�
p ARCHITECTS DECLARA 0—
ul3 I mi crsund my plans still be used u public records
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Licensed Pmfcssieusl
N
Oat I..BUILDER DECL Carrie N
COO Mroby.(Tian that 11, exempt from the Canuac Co eLicense A c Law for the
i.p O mhowmg maw n.ouant t R n Id,Business and Pmfessium Cade:Any city of county
which mgeros issuance.permit m cmnuua.alms,improsu demolish,ore a sig eny tracer il
xSn pristms Hemm tient Withe titeisio of for Carbonate,License Law em
Man
comme cingwitpursuwtmthcofDiviousefthe Me Business law(s Code)9 Sq.Ft. Floor Area Valuation
�r 3 that he Is Martin and do basis f r w tiro Alleged and Professions Code)of $47606
S .. that io ts 31.5 b Therefrom and the pars far we alleged aempnt to Any violation of
Session t= veairyapplicantfurapermitmblects theapplicantm•dullpenaltyof Number Occupancy Type
.t teem Nan E.a hundred acts,(>;3mL 32602065 �_
❑1,ss owner of the property,err mY wplvym with wags u Net wle e.mpewtion,
will do the wort and thesmictum is notmmnded woReted for Bate(Bee.7044,BumMu
and Farmhand..Ccwc:The Communities License Law dam,not apply m an owner of Required Inspections
property who builds orimprovea Neuron,and who deessnehwork himselforthmugh his
ownemploye s.provided that such Improvements are not intended ao @red for We IL
however,the building or improvement is veld within one year of eampledon.the owner-
Wilder will haw the burden of proving Nat he did net Mid or Improve for purpwe of
ask.),
❑I,u ownm of time property,am exclusively concocting with Iicamurd conuacmra in
construct the Mica(Sec.]Ode.Business and profession Code:)The Character's Li-
come law cores net apply in an owner of property who Wilds or improver thereon,and
who conuacu for such pm3a m with a controve(.)licensed puneant to the O.n rstand s
Liam law.
an
❑I mmcmpt order See .B A P C for this reason
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby ailbm under penalty of perjury one of the following cremations:
have and will madame a CemBam of Consent to self-imum for Workers Camper,
m,u provided for by Section 3700 of the Labor Cod.,for N.performance of the
rt for which this permit is issued.
QT-1 have and will msimse.Workers Compmuamm Isturumce,u required by Sc don
3700 of the Labor Cock.for the Kano..of the wart for which this perms is issued
My Workers Compensation lemur ace carrier aM Policy number am:
Cartier-, 4 et'a. Fr.- A Polk,No.:'.hp 17 3 3 3
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(nessectrhn need rwtbecamplmed]film permit is friction hundred dollars(SIM)
or want)
1 cedfy Net in we performarce of tite mark for which Nis permh to coned.T shall not
employ any persan in any minister an u m become subject to the Workeri Compensation
U.of Cable..Dry
Apptican
NOTICI,10 APPLICANT:1L after making this Cadrecom of Exemption,you should
become subject in tite Workers Compensation provisions of the Labor Code you must
.,O forthwith comply with such provisions or this perms shadl he deemed meted.
CONSTRUCTION LENDING AGENCY
[r Ihereby Aram than mere lam comuuctim binding agency for the performmm of
Lx the was for which this permit Is issued(Sec,3197,Civ,Cd
W A Under's Nor^
jz LendersAddis-
U O I marry that I have read ms application and sate was the above information is
IL^ comm I a&=in comply with all City and county adiomazs and awe laws mining b
0 Wilding conensatin.and hereby autherim mpoesenatim of NU city to enmrupon the
W above-motioned property for Inspection purpmwL
LL (We)agree to cave,indemnify and keep harmless the City of Cupertino against
IlaMhtia,judgmems,casts and expenses which may in any my accrue against said City
U F77 In consequence of Me gaming or this permit.
APPLICANT U EI STANDS AND WILL COMPLY WI ALL NON-POINT Issued by: Date
SOUR DNS,
a o _
'
Situagm a App o omranar DowQ
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tiro applicant or future building eceapwt nom a handle harudous material
u donned by die Cupertino Municipal Cads.Chapter 9.13,and the Health and Safety
Cede.Section]5532(U7
All roofs shall be inspected nor to an roofing material being installed.❑Ya N.
Will the applicant or future budding acupam saw equlpment or devices which If a roof is installed without first obtaining an inspection,I agree to remove '
L hoiadnus air amiaminans u donned by the Bay Am&Air Quality Management all new materials for inspection.
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tNavamadmclute u/nw:dmmquimmmtmdcrChapw6.95ofNUifo-
nkHalNkSafcty Ch Seeomm' N5,25533er =34.1 was Wilting
Jost not aurnagulijolave amen my bility fy me occupwt or the
oxf.t mh must d Aria too o cuponcy.
y�_/ Signature of Applicant Date
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Own er err authamctl occur Dam All roof coverings to be Class'pe'or better
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