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13090093
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21820 HERMOSA AVE CONTRACTOR:GREENTECH ELECTRIC PERMIT NO:13090093 OWNER'S NAME: VISWANATH DHULIPALA 12333 SARATOGA SUNNYVALE RD DATE ISSUED:09/12/2013 OWNER'S PHONE: 4083068727 SARATOGA,CA 95070 PHONE NO:(408)280-1180 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL[] License Class C/O Lic.# q§-oS � � . 0y INSTALL EVC CHARGING STATION ON EXTERIOR OF Contractor C7PEZ47- Y &WIRC % W 0� SFDWL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$500 ^Q 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35716055.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 1 0 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYCTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, � costs,and expenses which may accrue against said City in consequence of the Issued b M LAST CALLED INSPECTION. Date: q/p'a granting of this permit. Additionally,the applicant understands and will comply Y' with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. �} C/ 'Z%vZ oZ�/f RE-ROOFS: Signature Date I roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. . will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 25505,2 333 ndDate• 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDIN AGENCY G become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a 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,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date ALTERNATIVE ENtRGY PERMIT APPLICATION a� COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 950143255 GUPERTIN4 (408)TU-32,28•FAX(408)777-3333•buildirLgocupertino.org 1(� PROD cr ADDREss ;21g.20 HERNI VSA -A V RAI UE Al"B 5j' ow "NAS¢ 1/1S WA N A 7'y DH uL/PAI-A I PHoW (y/08) Soo d'I' SrREErADDRESS 2/$ ,0 #FA> lD6A AVS Can`'STAZE.zm CU1�El�T/NO, C4FA" COWACT NAME 44ANUE L CQR T/NAS CV08)280/180 x E-MAIL SrREETADDIMS CiTY.STATE,ZIP FAX ❑owNm ❑ owmm-aun,DER ❑owmaLAOmar 410cawmAcroR OcomvAcToRAGmT ❑ ARCMTEcT ❑R4GWEER ❑ DEVELOPER ❑TrrrwT CONPRACTORNAME MANUEL. LrCaivsENr LtCUMrvPF- - EMUCe G R TE.e-H ELEC R I C - -/O 3-,2$(P CCIWA"NAME H MAII. FAX C-s(RE15(4Te" CTR IC srREErADDREss/2333 SARATO&A SUNNWALE CrrY.STA1M Z1F PHONE SU TEM SARA TOAA, CA CLSb7to SARAT06A SA q113b7a 4O .280 —//$D ARCEArECr/ENGR4M NAME uCENSE NUMBER BUS.LIC 0 COMPANYNAME E RAIL FAX S1REEr ADDRBSS ary.=713.ZtP PHDNE USE OF pa"SFD or Duplex ❑ Multi-Family PROJECT IN WIMLA D MOIEcr IN STRUC MM ❑ Commercial J URBAN R4TWACE AREA ❑jYes IA NO -- fI 00D ❑ Yes ANO ❑SOLARPANELS ::]:�EL nucVEI aZCHARCiMsyATiotsi 0 SOLARWAMMICATM ❑ 01maL- FOR SOLAR PANEL£ NUMBER OF PANEISIUMM xxowATm(qob&BR(aAL 0MYk VALUA DESCRIPTION OF WORK i N STALL # AMP .240 I/OL.T ELECTRIC VC"I-[ICLE CHARGING DOCK ON THE EXTERIOR OP HWE By my signature below,I certify to each of thefoll0wiar I am the property owner or authorized agent to act on ownces behalf.I have read this application and the information I have provided is correct. I have read the Description of Work and vorify it is accurate.I agree to comply with all applicable local ordinances and state laws relating to building oa iize reptaterttatives of Cupertino to enter the above-i trfted pyperty for inspection purposes. Signature ofApplicant/Agent: SOPPLEM2NTALMFORMATIONREQUI]RED - PYApp 201 Ldoc revised 03116/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 21820 Hermosa ave DATE: 09/12/2013 REVIEWED BY: Mendez APN: BP#: *VALUATION: $500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY SFD or Duplex PENTAMATION SOLAR-RES USE: P PERMIT TYPE: WORK install evc charging station on exterior of sfdwl SCOPE x Xk-ch. flan Check Plumb,Plan Check Elec.Plan Check iLtec;h.Permit Fee: I Plumb.Permit Fee: liter•. Permit Fee: £)'then Afech.Insp_ Other Plumb Insp, Other Elec.Insp. EIF Rlech.Insp.Fee: Plumb. Insp.Fee: Elec,Insp,Fee: NOTE:This estimate does not include fees due to other Departments(ie.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Theseees are based on the prefinddna information available and are only an estimate. Contact the Dept for addn7 info, FEE ITEMS (Fee Resolution 11-053 Ef. 7/f 1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F 1-1 # Alternative Energy System Suppl.PC Fee: (E) Reg. Q OT 0.0 hrs $0.00 $106.00 ICHRGSTA EV Charging Station PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Insp.Fee D Reg. 0OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative.Fee: Work Without Permit? 0 Yes (2) No $0.00 0 Advanced Planning:Fee: $0.00 Select a Non-Residential 0 TravelDocumentation Fees: Building or Structure Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC 1 $1.001 1 r .. $1.501 $106.00 $107.50 Revised: 08/01/2013 Viswanana Dhulipala 21,820 Hermosa Avenue Cupertino,CA.95014 REAR YARD Scope:of Work: 4500 Sq.Ft Lot InstaI1 t1t 40 arnp charging dock at the exterior front of the home.insta 11 feeder from main utility panel to wall mounti:dk,chargiIng dock.Feeder tconduitor rornexwrire)will be mounted to existing surfaces. IIIIIIIIIIIIIIEWIrm AEROVIRONMENT EVSE--RS Di mensions:12`x1.2')W*approx Weight-10lbs excl.cable Cord Length:15'and 251va' s LIVING SPACE rn mrrn Fmn (D 0 FEkE ((D "1, s , Q O Co � c lam. 40AMPEVSE-FCS 100AMPTAAIN j "U' I NSTALL LOCATION n c �` SERVICE PANEL 3/4-EMT CONDUCT FRONT OF HOME j,P►�S ,D COMMUNITY DEVELOPME JT DEPARTMENT ren BUILDING DIVISION-CUPERTINO DRIVEWAY PRO D ROPERTY �I 2 This set of plans and specificatic ns MUST be kept the LINE 9p, � �. job site during construction. It unlawful to mala any • r. nrplforntinnqnn,:nmiz nr tn rinvinto, 4j,p►1`Z therefrom,without approval from + Building`r -4'Q61"ALK be held to permit or to k e an approval of theviolation STRE�rany provisions of any City Ordinance or S a e Law. By IVt< DATE PERMIT NO. t 'd d Rq, 4 Ct' ense ICA Ltaln-s wd, a er Si•;�iga: Gu PA . Building Depa,-tment f f^ 1 fMln1�R.Y tbtak.7 u� REVIEWED FOR CODE COMPLIANCE Reviewed © 2010 AeroVironment, Inc. All rights reserved INSTALLING THE EVSE-RS Basic Specifications: ■For use with Electric Vehicles ■Ventilation not required ■Rain tight Phases Amps Temp C Power Disconnect switch Charging Dock distribution (if applicable) panel Wall stud fly t r •.. pr 1 . Choose wire entry location HOLE IN REAR OF HOLE ON UNDERSIDE OF CHARGING DOCK CHARGING DOCK i i t O ' O 0 i O I o Bottom View j Rem Yaw 2. Attach the mounting plate pole eo 1"Mol"for oorWud Ubk wire, dame Dods mouaft h w o SaW Mob"for nwwding rlaft to wa stud O Flat washer Lag bolt WalSw O O O«--- ------------------0------- 0 Q.----- ---------------- ------- ,8" O Wail stud (I 3. Attach the Charging Dock to the mounting plate Upper mounting.hole Flat washer Socket head screw - -= ---------------------MWO ------- ---MWO 0 i 0 rte.' 4. Wire the Charging Dock Terminal Block Ground Strip ti Ground Wire Two power wires p $f f L '? o '�o INSTALLATION 5. Install the front cover #10 Tont screws-Torque 12inAb rl 1 Removing the trim ring Am AD"b0» Ow;ling 6. Complete the installation 0 0 w t b ' FRONT PANEL COMPONENTS POMMaM Tho charging dock is recah" AC power RMYTO CHARGE srA�r The charging dock is ready to vocrr b Press to begin a charge.The charge orcharging Is pausedPOWER PRESENT and READY ,reQ o RT TO CHARGE lights nwst be on cow amw b v� b st The connector Is properly. STOP connected to the vehicle portPress to manually stop charging or the charge Is oomplete. The device will stop automatically when it reaches M charge. V84Kl6 CFfApfAM The vehicle is being charged. TAWKE There Is an error. Try removing the connector and insortlng back into the veNdQ.If Trouble Inrtcator is stil Aluminated call Custamor Service at t(877)NO GAS EV or h W7)664-2738 or —•• visit Customer Service on the Rau%ASE BUl fON web at wwwnissarwsa.mm/baf. Press to release tha Connector from the charging dock or the vaNde port CHARGING THE VEHICLE %a Vw button on Ow unnrap#m cable from c«+nador b teteaee k .,a Ina�bl�t y�. ntA z>,a dw"lock vettlkx�corNtect� .w.Rommw 0 Cheartawwtor into ttw ••"•"w• raa+x+aww,t o. Charg�ngwil bagpa whplu dm�a port WWwommoa amm a *+: Uy incerted.the VENNIC11 Volas0 k harping bogina.the CONNECTED light on the G darging dock wil Nwntnate. VEHICLE CIORGM light VAN begin lo blink.There N no need to prose START. VEHICLE CHAPAN0G Ctiarging wdi atop autamaNr Ety r VAm the VEH)C.E "�"•: when compk te. You can rnanu* r CHAfaGNG Mgltt elope atop changing by pracaMg STOP. bk"V on the darger. When the READY 1C}CHARGE preas she button on the fight blinks.r m*w the cormactor connector b naeaea. from the vdw&charge port.F Pul to nanwe from you have proceed STOP.you can yehicie d-Va fort prase START to rasunw charging. k The EVSE RS Home Charging Dock charges all SAE J1772-compliant FEATURES vehicles—including both electric vehicle(EV)and plug-in hybrid • SAE J1772 compliant ''� 'Y WHEY)models—in the convenience • Auto restart in event of �'f of the home garage,workplace, ground faun rO9e or . �; -"�� condominium,apartment,or retail • Americans with Disabilities Act(ADAj parking structure.The Home Charging compliant installation Dock safely and reliably delivers AC power to the vehicle's on-board • Integrated cable stowage,optional charger and features a weather- cable management resistant NEMA 4 enclosure for indoor • Underwriters Laboratory(UL)listed and outdoor installations. • Breakawaysaf*c'able ft-p' dwilm VeaKW' • Optional pedestal rrtou • Wireless,communication:option The Home Charging Dock is installed by one of our independent certified licensed electricians who also facilitate necessary permitting and inspection, and provide information about EVSE-RS use to the customer.An optional SERVICE AND INSTALLATIONmodule is used to enable MF,Zigbee,or cellular communication. Will be supported by: • Expanding network of independent certified,trained electricians* INTUITIVE USS WEVACE • Convenient home site assessments —, GREEN=uftvottaga cormected' and installation readyl3ooperaft • Electricians with depth of local code and GREEN 6UNXWG="o1f'state dueto a manual STOP Permitting knowledge -~ GREEN=cmwctedtaveWc1e GREM=ve*kischariingUastbW(mg=high charge when battery is W4 slow bEa"g=charge pear complete) RED=error has occurred;bkftg pattern based on tauittype •ImWlabonswvkesavailableMcertainarea3;00nW tAVforadd*mafwfomution. ®2010 AeruVkum Inc. 7010 10147 SPECIFICATION EVSE-RS Connector SAE J1772 Voltage 208VAC to 240VAC Frequency 50Hz/6OHz Current 30A max Operating Temperature -30'C to 50*C Storage/Transit Temperature -40*C to 600C Humidity Up to 95%non-condensing Dimensions 12"x 12"x 8"(approximate) Weight 10 lbs.(excl.cable) Cord Length Up to 25'available Enclosure NEMA 4 Regulatory Compliance UL listed,CSA and CE pending lnformadon andspeacations subject to change 02010 Aero\AnmunerK,kw- 1010_10147