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12030096CITY OF CUI'E.IZTINO BUILDING I'L12NIL1' RUD,D1NG Am mESS: 11842 PLACER SPRING Cf cos'I'ItACrolf: SCIAEFER I iI wNIl'I'NO: 12030096 ELECTRIC CO INC O\%'NICit'S NAJIIC: LAI .,IRI ASHOK AND RANGANA 2346 LI:P'I'TS C 11 DATE ISSOED:03/19/2012 OW.vmrspnONE:4082551156 MORGAN MILL. CA 95037 PIIONItN0:(408)776-1050 ,GY LICENSED C0.NT tAC'I'Olt'S DrCLARA'1'I0N r r r G q 8 Z/ 3 2/ It Ii I LDING 1.1[10111' INFO: Russ: M.ECI' 1'110>m License Class 0 'c. N r r r 3' (9-2bIZ ?11.,[11 It I$$IU&\'I'h\L. CO?I dI h12Ch\I. Contract, _ ,Ile .108 DESCRII''1'10.N: INSI'AI.I. tiVCC10\ItGING S'I'A'1'ION IN SPUWLGARAC71i I lie, ch., al"firm that Inn, Iirenuvl 11 filter Ute prucisio its of Cha liter AREA (eo nuneneing %,-flit Section 7111111) ml'Ui %isiun 3 ol'ihe It usinese .\ I'nd'eaions Code nod that Illy license is in 1'1111 ruler and c11'ect. I item]),- affirm under penally o1' per 111.3 one uI the folimw'i mg Iris deel:va tions: I hace and will maintain a certificate mf Consent Io Sell -insure Ibr Worke'r's Compensation, as provided for by SCCd0n 3700 of the Labor Code. tin the Sq. FI Floor Arca. Valuation: 51200 performance oithe work for %c[lic]) this permit is issacd. I have :aid will maintain Worker's Compensation Insurance, as provided lir by Section 3700 of the Labor Code, lot the perlor namc of the work lir which this AI'N Nootlwr: 36655002.110 Omlpancy T1 pe: permit is Issued. AITLICAN"r CER I"IFIC\'lION I cenify that l have real this application and state that he above information is PFRN'IIT Exi?J21iS IF\YORK IS NOTSTARTED correct. Iagrcc I0 Comply with all cit•rout coumy one im11ues :eat slate laws relating building hereby of this city to enter \V I -I III :\1'S OF PERN11'I'ISSUANCE' OR to construction. rood authorize representatives upon the above mentioned property for inspection p11rposw. (We) agree to SayC 1811 DA)LAST GALLED INSI'I':CTION. indemnify Laid keep harmless the Cit• ol'Cupertino against liabiliiies•jndgniciio, a01'01C costs, nd C.ypeucs wHoly which Hoaaerie a@Linu said City in. a,nsequaae 0i the YON1 5 L Issued hp: Dale: bob eructing of this ^mit. AdititionalIv. the appl isant utide isbin ds ;aid %rill comply %rich all non- urec reguhtions pe • Cu ert .,110 Municipal Code. Section 9.18. ` � / It h: ROOFS: Sign) _Date All roofs shall be inspected prior to any cooling material Heine installed. flit tool is installed without first Obtaining :ill inspection. I agree to remove all new materials li+r inspection. ❑ O\\'Nh;lt-11111 LIIIiR III?CL,\IL\'I'IUN Sigmuurc of App]ica t: Date: ' I hrre[)3 allirm that I :un cu•ngll I5'um the Cmnb'aetur's License L:mlie" one (it Ua• fidlun ing avis reasons: ALL ROOF GoNTRINCS TO BF CLASS "A" 012 Iih"I'ITR 1. its to'ne'r of the property, or Illy enlployces with wages its their sole Compensation, will do the work, and the structure is not intended or Offered li)I side (Sce.70,14, Business .l• professions Code) 1, as myner of the property, aura exclusively contracting with licensed contractors to I IX7.A1 IMUS .MA I FIt1AIS DISCLOSURE. canSLr;cl the project (SCC.70.14, DuollCSS.0 Professions Code). I lin ,c read the hazaI dons 11atcr i:ds req of reme n is under Cltaptvr 695 01 the California I lealth .@ Safely Code. Sections 2550.,. 25;33. and 2.,534. 1 will I here[),- affirm under penalty of prrjurp unr of Ihr follow'ime three 11lainlsin compliance with Ihr Cupertino Municipal Code. Chapicr9.12 and tea• declaraliuns. I Icalth & S:d'ets' Codc. Section 255,12(a) should I store n1. handle hazardous I have and will. maintain a Certificate of Consent tosell'-insure tiff Worker's states :11. Additionally, shuulil I use euptipntern or. derives which emit hazardous Compensation, as provided or by Section 3700 of the labor Code, Ibr the air amtanlill a b :IS 11l•IIIIC(I by the Ilay Arca Air Quality Managcutemt Ili.slrict I performance of the work for which this permit is issued. I 1 have and will maintain Worker's Compensation IIISLIN IC -C•, as provided lir by will rnainlain cont pli:olrr wish thy'/Cupertino dlumcipal Code. Chapter 9.12 and lite Ilcalth 'cls• \ Sa1Cady. Se f (. ?5511$ 155 d 2.,534. %) Section 3700 of tlic Labor Code, for the perfonn;uice of thc%%ork Ibt which this '(M%'mer ??� permit is issued. or amhnrizrd :Itr an•:_ I certily than in the perlbnnamce of the %cork for %%hick this permit is issued, I shall not employ any person in any manner so its at become subject to Lite Worker's (:ONS'I'ItUC'I'ION' Lp:NUIN'C :\CL;NC1' Cormpcnfsation Encs oCalililntia. If, aIle making this ccrtilicate of nemption. I become subject to the Worker's Compensation provisions ofthe Labor Code. I mast I hereby affirm Ihal there is it construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Cir C.) Lender's .,Naar (TI(TIFIC,\ ]'ION Lender's Address I ccrtifv that I have read this application and state that the above iri rntation is correct. I agrcc la comply with :111 city and county ordinances and sane laws relating ' to building construction, and hereby authorize representatives of Itis cit' to enter upon the above mentioned property for inspection purposes. (We) agree to save I I'I'I.,(."I"S UHCLAIt,\'I'IIIN indenmifj• and keep harmless the City of Cupcttino against liabilities, Judgments, :\It(:I costs, and espenses which may accrue against said City in c0nsequcnce of the I understand my plans site]] he used as public records. granting ol'this permil. Additionally. Lire applicant understands and %vill comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9,18. Sieniltirc Dale ' 0 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: B1k: Lot: APN ......... 36655002.00 DATE ISSUED.......: 03/19/2012 RECEIPT k.........: BS000016310 REFERENCE ID 8 ...: 12030096 SITE ADDRESS .....: 11842 PLACER SPRING CT SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OPERATOR: SylviaM COPY u : 1 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 101.50 --------------- 101.50 VOICE ID DESCRIPTION -------- ------------2--------------- 301 ROUGH PLUMBING REFERENCE NUMBER -------------------- mc VOICE ID DESCRIPTION -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 313 ROOF NAIL 505 FINAL ELECTRICAL 507 FINAL PLUMBING .508 FINAL MECHANICAL OWNER .............. LAHIRI ASHOK AND RANGANA ADDRESS ..........: 11642 PLACER SPRING CT CITY/STATE/ZIP ...: CUPERTINO., CA 95014-5102 RECEIVED FROM ....: CHRIS SCHAEFER CONTRACTOR .......: CHRISTOPHER SCHAEFER LIC N 32968 COMPANY ..........: SCHAEFER ELECTRIC CO INC ADDRESS ..........: 2346 LEPTIS CIR CITY/STATE/ZIP ...: MORGAN HILL, CA 95037 TELEPHONE ........: (408) 776-1050 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC --------------------- NEW •BAL ---------- 1BCBSC ------------- ---------- VALUATION 1,200.00 ---------- ---------- 1.00 0.00 1.00 0.00 1BSEISMICR VALUATION 1,200.00 0.50 0.00 0.50 0.00 1CHRGSTA UNITS 1.00 100.00 0.00 ---------- 100.00 ---------- 0.00 TOTAL PERMIT ---------- ---------- 101.50 0.00 101.50 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 101.50 --------------- 101.50 VOICE ID DESCRIPTION -------- ------------2--------------- 301 ROUGH PLUMBING REFERENCE NUMBER -------------------- mc VOICE ID DESCRIPTION -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 313 ROOF NAIL 505 FINAL ELECTRICAL 507 FINAL PLUMBING .508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE. This estiraatte docs not include jeer time to other Departments (i.e. Planning, Public Warks, Fire, Saninuy Sewer District, School District, ele.). These fees are based on the nrelinrnary infonmttion available and are onh, an estinwte. Contact the Dent for adda'l info. FEE ITEMS fFee Resolution 11-05+ Eff 7.1.1'11/ ADDRESS: 11842 Placer Springs Ct. Phnab. Plan Cherk DATE: 03/19/2012 REVIEWED BY: gs Plumb. Permit Fee: APN: BP#: 011ie), Plumb hasp. "VALUATION: $1,200 'PERMITTYPE: Building Permit PLANCRECKTYPE: Addition PRIMARY SFD or Duplex USE: $0.00 PME Plan Check: PENTAMATION SOLAR -RES PERMIT TYPE: WORK SCOPE Permit Fee: $0.00 NOTE. This estiraatte docs not include jeer time to other Departments (i.e. Planning, Public Warks, Fire, Saninuy Sewer District, School District, ele.). These fees are based on the nrelinrnary infonmttion available and are onh, an estinwte. Contact the Dent for adda'l info. FEE ITEMS fFee Resolution 11-05+ Eff 7.1.1'11/ Afeelt. Plan Cheek Phnab. Plan Cherk Flev.. Plau Check Aleah, Permit Fee: Plumb. Permit Fee: Elec, Permit Fee: Ohher Jlech. hap. 011ie), Plumb hasp. Other rice. hasp. Li I Ale.h. Insp, Few: Plumb. hrop. Fee Fire. Imp. Pae: NOTE. This estiraatte docs not include jeer time to other Departments (i.e. Planning, Public Warks, Fire, Saninuy Sewer District, School District, ele.). These fees are based on the nrelinrnary infonmttion available and are onh, an estinwte. Contact the Dent for adda'l info. FEE ITEMS fFee Resolution 11-05+ Eff 7.1.1'11/ FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # $100.00 Alternative Energy System ICHRGSTA I EV Charging Station Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feel@ Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Admini,rlrative Fee: Q 0 Work Without Permit? O Yes (D No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Tnrral Dax:urncnlcrtion Fear: Shone Motion Fee: IBSEISAIICR $0.50 Select an Administrative Iter Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $100.00 TOTAL FEE: 1 $101.50 Revised: 1/19/2012 Wiring information 0 GND .. 40A,2 POLE BREAKER MAYBE CONNECTED TO ANY TWO PHASES RECEIVED MAR 19 2012 BY: DEVELOPMENT DEPARTMENT G DIVISION - CUPERTINO METER ns o'Tblb set ofrplans in _or job unlawful UST to mept at the ake any rha i e or alterations on same, or to deviate that ithout ap ;rwal from the Building Official. MIL Thi ;ti � IMA 2 this pl in arid specifications SHALL NOT I e hf IeAeAK�xan nit or t 011y approval of the violation o any {irovi�Ions of E Ordinance® Sate Law. l U Introduction 1-3 ChargePoint® Charging Stations Specifications C us LISTED Electrical Input 7.2 kW Input Power 7.2 kW 208/240 VAC Output Current Input Voltage 208/240 VAC Output Charging Connector SAE J1772t"^ EV connector on 18' (5.48 m) cable Input Current 30A 2:4 GHz 802.15.4 dynamic mesh network Wide Area Network Input Power Connections Line 1, Line 2. Earth Operating Humidity pical Required Service Panel Breaker 40A double pole breaker (non-GFCI type) on dedicated circuit NE i�R�l4 J! Terminal Block Temperature Service Panel GFCI Do not provide external GFCI as it may conflict with internal GFCI (CCID) Ratingaq' ...ty , �� NJ Standby Power 5 W ty 0 (each station must be within 150 feet "line of sight" of at least one other station) �nom.. 802.15.4^Rartf� ro • Electrical Output Approximatp,;�hipbing Weight 261bs (12 kg) Functional Interfaces Safety and Operational Ratings IZzECEIV D MAR 19 2012 BY: i -z Output Charging Power 7.2 kW Output Voltage 208/240 VAC Output Current 30A Output Charging Connector SAE J1772t"^ EV connector on 18' (5.48 m) cable Local Area Network 2:4 GHz 802.15.4 dynamic mesh network Wide Area Network Commercial CDMA or GPRS cellular data network Operating Humidity pical Output Charging Power 7.2 kW Output Voltage 208/240 VAC Output Current 30A Output Charging Connector SAE J1772t"^ EV connector on 18' (5.48 m) cable Cab Reader ISO 15693, 14443 Ground Fault Detection 20 mA CCID with auto retry (15 minute delay. 3 tries) Plug -Out Detection Power terminated per SAE J1772T"'specification Power Measurement 2%®15 minute intervals Local Area Network 2:4 GHz 802.15.4 dynamic mesh network Wide Area Network Commercial CDMA or GPRS cellular data network Safety Compliance UL listed for USA and cUL certified for Canada: Complies with UL 2594, UL 2231-1. UL 2231-2, UL 1998, UL 991. and NEC Article 625 Surge Protection 6 kV ®3000 A. In geographic areas subject to frequent thunder storms, supplemental surge protection at the service panel is recommended. EMC Compliance FCC Part 15 Class B Operating Temperature -221F[o 122°F(-30°Gto+50°C) Operating Humidity Up to 95%noncomen°5ing Enclosure NE i�R�l4 J! Terminal Block Temperature X21 °F�j'1 , Ratingaq' ...ty , �� NJ Maximum�,�Cha`rgi � Ip" p8F 0 (each station must be within 150 feet "line of sight" of at least one other station) �nom.. 802.15.4^Rartf� ro • r Approximatp,;�hipbing Weight 261bs (12 kg) Ce�r� ��Per E Ina GA 150 A Mai A Sj,-- PNL %' N Cvv,S V - fMC 5VS E MAR 19 2012 �,EGzuiPwt�-�(T� Lr d New TOV `{O A c)r-+ (:r�'P�s `7 DATE PLANNING DEPT. DATE ' mrr:. ncvr- 1 GENERAL PERMIT APPLICATION M E R COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 M I GUPERTINO (408) 777-3228 •FAX (408) T77-3333• buildinG(a)cuoertino.ora `\7J444 ❑PLUMBING ❑MECFL+NICAL t CTAICAL IINRSCII.I.ANTEOUS PRO= ADDRESS G�.. APN# OWNER NAME1//„yy_ rs(�/.K?i PHONE (�^ // I(�/ ENAB,I (r O edA C STREET ADDRESS . C CITY G�-C•`{T Irl ls�'. . STATE, -1ZIP/' .vGJ�JC4_ oA K/OI FAX CONTACTNAME �o0V1/-Q,��� ONE Iao(8J�l0 `- STREET ADDRESS 2-3`4 - Y 6 _ I � `.j`l.-,// 7WNER,' . CITY, sTAIE.T Q/vL �(j {,tyn7ov (CIQTE� `T _l❑ FAX ❑ OWNER ❑ OWNER -31M ER ❑ 0 .'AGENT mMICTOR ❑ CONTRACTOR AGENT ❑ AR` E (BNIER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME C_r e C p /UJL LICENSE NUMBER S Q LICENSE�T�YPPE�,/) () BUS. LIC# -3-L%Q ✓L�IIYJ�U�✓ COMPANY NAME L(j,.�( EMAII.3CjSICt�'eI ILE1�C.�.I���1'V.✓C..i�l F (� STREET ADDRESS 2'L LI / b p I ,. ,I 5' / ,IC- `%� TtJ `/l CIN. STATE, ZIP �/, 41 I PHONE a p 776- I aso ARCHnECT/ENGLYEFR N✓✓AME LICENSE NUMBER BUS. UC # COMPANY NAME ' E-MAIL FAX 5-IREET ADDRESS CITY. STATE, ZIP PHONE USa.OF SFO or DUPLEX atMDING: ❑COM. tnAL ❑ MULTI-FAMLY PROIECTINwLDLAND ❑ YES PROIECTIN ❑YES URBAN INTERFACE AREA 42� 0 FLOOD ZONE cl No t5 THE 3LDG ANa❑AYES ELER CHHC. E IE NO DESCRIPTION OF WORK `/J T'7 , V v / ke `ilan� f� LrJ 0.KXo 2. t o s ✓c t n1 ' Q') r 3lLC G e-vl � 2� E TOTAL VALUATION: ©Q®" RECEIVED By: By my signature below, I certify to of the following: Into the property owner or authorized agent to act on the property owner: s behalf. I have read this application and the information I avvi d is c mel, v d the Description of Work and verify it is accurate. Cagree :o corrnily with. all applicable local ordinances and state laws relad g u' g c : ,I o ze entatives of Cupertino to enter the above-idwtifxd mpertyyfor inspection pufposes. Signature of Applicanr/Ag Date: �— —2,0 1 zt SUPFL MAL INFORIMATI N REQUIItED OFFICE USE ONLY v OVER-THE-COUNTER Y ❑ EXPRESS U ❑ STAYOARD U ❑ LtRCE ❑ MAJOR A4EF,Nrsa.4pp_2011.don revised 0 612 1111 .Cdr