14030141I CITY OF CUPERTINO BUILDING PERMIT I
1 BUILDING ADDRESS: 10580 SAN LEANDRO AVE I ELECTRIC INC R: WILLOW GLEN I PERMIT NO: 14030141
OWNER'S NAME: THARMALINGAM GOPITHARSHANA AND SU 11085 WARREN AVE 1 DATE ISSUED: 03/25/2014 1
OWNER'S PHONE: 4084105348 ( SAN JOSE, CA 95125 1 PHONE NO: (408)289 -9725 1
❑ LICENSED CONTRACTOR'S DECLARATION
License Class C-10 Lic. 4 571918
Contractor W I II O W G I eM E WC}-n L Date
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.
I 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
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
Signature 6]U " ` Dated s r y
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
I 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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
Signature.
Date
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E]
INSTALL (N) 50 AMP BREAKER FOR NEMA 14 -50 PLUG IN
GARAGE FOR EV CHARGING. (N) DEDICATED CIRCUIT
IN
(E) SUB PANEL
Sq. Ft Floor Area: I Valuation: $1400
APN Number: 35705070 00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 1A0 DAYS OF PERMIT ISSUANCE OR
180 DAY OM LAS CALLED IN SP CTI /O`N.
Issued by: Date o c `7
RE- ROOFS:
All 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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25553_3,, and
25534.
Owner or authorized agent: / Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CUPERTINO
ALTERNATIVE ENERGY PERMIT APPLICATION � 1
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION `
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (\
(408) 777 -3228 • FAX (408) 777 -3333 • building (o1cugertino.org V�
U4
PROJECT ADDRESS 10580 5ar Lxandlro Avf- .
'3507_765-7
0 S 0 _I c) -�,J
OWNER NAME
S v„ anKGC S )VDWCIV)i0lrl
PHONE
Lig_ 41 -53q8
E-MAIL
STREET ADDRESS
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CITY, STATE, ZIP / �
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FAX
CONTACT NAME
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PHONE
09- 705-';t)63
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STREET ADDRESS 170 (Z,Q / ti j/7!
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CITY, STATE, ZIP C u N ��� r7 C1��
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FAX
❑7lOWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT
❑ OWNER ❑ OWNER-BUILDER
CONTRACTOR NAME & C G
LICENSE NUMBER
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LICENS jF TYP�
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BUS. L[C # .591 ?I (�
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COMPANY NAME I�
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FAX
STREET ADDRESS PO ( 0g 3 430
CITY, STATE, ZIP S-T 5/,2 J C
PHONE
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ARCHITECT /ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi- Family
STRUCTURE: ❑ Commercial
PROJECT IN WILDLAND
URBAN INTERFACE AREA ❑Yes ❑ NO
PROJECT IN
FLOOD ZONE [3 Yes ❑ NO
❑ SOLAR PANELS
%-ELECTRIC VEHICLE CHARGING STATION
❑ SOLAR WATER HEATING
❑ OTHER:
FOR SOLAR PANE/ S.• NUMBER OF PANELS /UNITS: # KILOWATTS:
TOTAL VALUATION
DESCRIPTION OF WORK 50 /� A(� A� /F
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VOW -OW „ .
REC D
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prope owner's behalf. I have read this
application and the information I ha v r vided is correct. I have read a Description of Work and verify it is accurate. gree to comply with all applicable local
ordinances and state laws relating t ing construct' I authoriz9orrepresentatives of Cupertino to enter the above- i ntifiedd property for inspection purposes.
Signature of Applicant/Agent: Date: dS�l7
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
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❑ OVER - THE- COUNTER
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PVApp_2012.doc revised 06120112
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
im, ADDRESS: 10580 San Leandro Ave
DATE: 03/25/2014
REVIEWED BY: Mendez
APN:
BP #:
EVALUATION: 1$1,400
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
USE: SFD or Duplex
1F # Electrical
$139.00 1BREMMISC I Apparatus
PENTAMATION
PERMIT TYPE: 1 REAP
WORK
install circuit with outlet for car charger
SCOPE
$0.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Nire, sanitary Sewer District, school
nicirint atn ) Th— £ooe — hncad nn tha nraliminary infarm" inn ovailahlo and oro nnly an o.wimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 Ef 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
1F # Electrical
$139.00 1BREMMISC I Apparatus
Suppl. PC Fee: Q) Reg. 0 OT
0.0
hr's
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee: Reg. C) OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
Tax:
T-F £Jrts�? "dtL'Z7�Jl
Administrative Fee: IADMIN
$44.00
0
E)
Work Without Permit? ® Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
1 Building or Structure
0
0
i
Travel Documentation Fee: ITRAVDOC
$47.00
Strong- Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg* Stds Commission Fee: IBCBSC
$1.00
`' MOW Ti
$139.50
$139.00`,__'1:'k,
TOTAL FEE:
$278.50
Revised: 01/15/2014
Shankar Suvramanian
10580 San Leandro Ave.
Cupertino, CA 95014
z
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e:
i
i'
CUPERTINO
,3uiidinq Department
REVIEWED FOR CODE COMPLIANCE
MOBILE CONNECTOR - NEMA 14 -50
DETAILS
INSTALLATION GUIDE
To take full advantage of your Tesla Mobile Connector, work with
an electrician to install a NEMA 14 -50 outlet where you plan to park
your Model S.
To ensure uninterrupted charging at full power, the circuit breaker
should be rated for 50 amps.
You'll find that charging your car is a lot like plugging in your cell
phone. For the best experience, we recommend plugging in each
evening, or when convenient.
• Voltage: Single phase, 208 -250 volt AC supply, 60 hertz
• Current: 50 amp circuit breaker / 40 amp continuous draw
• Code: Circuit installation should meet National Electric Code
(NEC) wire and breaker ratings. In general, this means 6 AWG
wire for installations under 100 feet
• Ground Fault Circuit Interrupter (GFCI): Not required
• Service disconnect: Not required
• Outlet: Install within 15 feet of driver side taillight (vehicle is
over 16 feet long) and minimum 18 inches above the ground
Ij G
250 V
E�
NEMA 14 -50, Ground on Top
Image to scale ( -2.25 diameter)
RECOMMENDED OUTLET LOCATIONS
One or two vehicle garage
Three vehicle garage
■ ■
Need help sourcing an electrician, or have questions about home charging installation?
Email Tesla at: Charging Installation @teslamotors.com or 1 -877- 798 -3752
Standard Method Load Calculation for One - Family Dwelling
Site Location:
Shankar Suvramanian
10580 San Leandro Ave.
Cupertino, CA 95014
Prepared by
Willow Glen Electric, Inc.
PO Box 8430
San Jose, CA 95155
(408) 289 -9725 - office
ILLOW
LEN
LECTRIC
General Lighting and Receptacle Loads [220.12)
1 Do not include open porches, garages, or unused 3 watts x
3,358
=
1
10,074
or unfinished spaces not adaptable for future use.
{sq. ft using outside dimensions)
Small- Appliance Branch Circuits [220.52(A)]
2 At least two small - appliance circuits 1,500 watts x
8
=
2
12,000
must be included. [210.11(C)(1)]
(minimum of two)
Laundry Branch Circuits) (220.52(8)]
3 At least one laundry branch circuit 1,500 watts x
1
=
3
1,500
must be included. [210.11(C)(2)]
(minimum of one)
4 Add lines 1, 2, & 3
4 23,574
Unes 5 through 8 utilize the demand factors found in Table 220.42
5 23,574 - 3,000 =
5 20,574
6
0 - 117,000 =
6
0
(line 4)
(if <117,000, skip to line 8)
(line 5, if >117,000)
7 0 x 25% =
7 0
20,574 x
35% =
8
7,201
(tine 6)
(smaller of line 5 or 117,000)
9 Total General Lighting and Receptacle Load 3,000 +
0 + 7,201 =
9
10,201
( line7) (line 8)
Fastened -ln -Place Appliances [220.53) Microwave(s) = 1,250
Dishwasher = 1,152
Garb. Disposal(s) = 1,776
Use the nameplate rating.
Do not include electric ranges, Trash Compactor = 780
Hood Exhaust = 360
Gas Range(s) = 240
clothes dryers, space- heating
equipment, or air - conditioning Refrigerator(s) = 780
Instant Hot H2O =
Jacuzzi /Suana = 1,440
equipment.
30
Exhaust Fans = 480
Office = 600
Entertainment Center = 600
Steam Shower = Bath
Radiant Heat = 1,200
Wine Fridge(s) = 396
If fewer than four units, put total volt- amperes on line 10
11,054 x
75% = 10 8,291
If four or more units, multiply total volt- amperes by 75%
(volt -amps of four or more)
Clothes Dryer(s) [220.54]
(If present• otherwise skip to line 12.) Use 5,000 watts or the 80% x
240 x 30
=
31 nameplate rating, whichever is larger. Derating
Volts Amps
11
5,760
OR
Name Plate Rating of Clothes Dryer =
(The neutral demand load is 70.0 for feeders. [220.61(B)]
Ranges, Ovens, Cooktops, and Other Household Cooking Appliances Over 1750 Watts [220.55]
(If present; otherwise skip to line 13.) Use Table 220.55 and 80% x
240 x
=
0
all of the applicable Notes. Derating
Volts Amps
12
AND IF OR
12
Name Plate Rating of Cooking Appliances =
(The neutral demand load is 70% for feeders. [220.61(8)]
Heating or Air - Conditioning System (Compare the heat and
13
A/C, and omit the smaller.) [220.60] Air Handier /Furnace
Include the air handler when using either one. For heat
115 x 6.0
=
pumps, include the compressor and the maximum amount of
Volts Amps
electric heat that can be energized while the compressor is Air Conditioning Unit
11,394
13
running. 80% x
240 x
-
-
Derating
Volts Amps
AND /OR
Name Plate Rating of Air Handler & AC Units = 10,704
Largest Motor (one motor only) [220.50 & 430.24]
14 Multiply the volt - amperes of the largest motor by 25% 125% x
240 x 0
14
0
including the 80% load factor Derating
Volts Amps
Total Volt- Ampere Demand Load
15 Add lines 9 through 15 to find the minimum required volt - amperes.
15
35,645
Current Minimum Amperes
Divide the total 35,645 - 240 = 148.5
mesh
'NN5�
2 Amps
16
volt- amperes by (line 15) (voltage) (minimum amperes)
, a
17a
CO i tly
the voltage.
Electric Vehicle [625.14]
18 Electric vehicle charging loads shall be considered to be 100% x
240 x 50
=
18
12,000
'
continuous loads. Derating
Volts Amps
Multiply the volt- amperes of the EVSE by 125%
Minimum Amperes with Added Load
Divide the total 47,645 - 240 = 198.5
19
,• ' "
%r '
20
2010 mpa
volt- amperes by (line 15) (voltage) (minimum amperes)
h "a d load
the voltage.
NOTES
ON
OFF
Address
�\ I I z
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building acupertino.org
? Sew LeG
-7- IAI
R _01/
r l o3 c,
PURPOSE
This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single- family and multi- family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within.each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
S,
h r m
Signature ........... Date: ..
. ........ ... ......................................... ... ..
Contraa �qor Nam//e--:
�J fII
�.. (Ji
Signature... .. ... ...... .. . .. Lic.# ....`.... `. Date:
Smoke and CO form.doc revised 03118114