Loading...
B-2016-1434 PERMIT, APP, FEE ESTCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1434 22248 HAMMOND WAY CUPERTINO, CA 95014-6576 (342 58 004) (SOLARCITY CORPORATION) SAN MATEO, CA 94402 OWNER'S NAME: THOMPSON MICHAEL T TRUSTEE &ET AL DATE ISSUED: 02/25/2016 OWNER'S PHONE: 4094641900 PHONE NO: 6504776430 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C10 Lic. #888104 Contractor (SOLARCITY CORPORATION ) Date 2/25/2016 X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing _ with Section 7000) of Division 3 of tare Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: INSTALL (N) ROOFTOP MOUNTED SOLAR (8.06 KW) - 31 PANELS I hereby affirm under penalty of perjury one of the following two declarations. i. 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. 2. 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. Sq. Ft Floor Area: Valuation: $17500.00 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 APN Number: Occupancy Type: ordinances and state laws relating to building construction, and hereby 342 58 004 authorize representatives of this city to enter upon the above mentioned properly for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and PERMIT EXPH2ES IF WORK IS NOT STARTED expenses which may accrue against d City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, licanl understands and will comply with all non -point source r ul 's per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code, Section 9.18. Issued O'SULLIVAN Signature Date 212512016 Date: 2/2/25/20162016 5 RE -ROOFS_• OWNER-BUILIY I R DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed If roof is following two reasons: installed without first obtaining an inspection, Iagiee to remove all new materials for r. I, as owner of the properly, or my employees with wages as their sale inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: 2. 1, as owner of the property, am exclusively contracting with licensed Date; 2/25/2016 contractors to construct the project (Sac.7044, Business & Professions Cade). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. I have and will maintain a Certificate of Cousent to self -Insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6,95 of tine z. 1 have and will maintain Worker's Compensation Insurance, as provided for California Health & Safety Code, Sections 25505, 25533, and 25534. I will by Section 3700 of the Labor Code, for die performance of the work for which maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the [his permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous a. I certify that in the performance of the work for which this poradt is issued, I material. Additionally, should I rise equipment at- devi will • emit hazardous shall not employ any person in any manner so as to become subject to die air contaminants as defined by the Bay Area Air Qua , M jj gement District I Worker's Compensation laws of California. If, afior making this certificate of will maintain compliance with the Cupertino Monte' 1 b, Chapter 9.12 and the Health & Safety Code, Sections 2550 , 55 , and 25534. exemption, 1 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall Owner or authorized agent: l� be deemed revoked, Date: 2 25 2 1 APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is CONSTR--- I hereby affirm that there is a cthustruction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant ARCHITEcT,S DECLARATION understands and will comply with .all non -point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Signature Date 2/2512016 Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO. CA 95014-3255 AE (408) 777-3228 • FAX (408) 777-3333 • building(dicupertino.org PROIECFADDRESS •✓ OWNERNAMB Ni_ t k� �\© f O y� � PHONE �-i o � .. 4t 6 �I _ 1 E-MAIL STREBTADDRESS TY, SiATEii ZIP FAX CONTACT NAME Marjan Javanmard EHD"I'650.477.6430 P-MAB. mjavanmard@solarcity.com STREETADDRES5391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 1FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR O CONTRACTOR AGENT ❑ ARCMTET ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACrORNAME SoIarCity Corporation L(CENSENUMBER 888104 LICENSETYPEC10 BUS. LIC#288 (1 VV`t 1 COMPANY NAME SoIarCity Corporation E-1IAIL mjjavanmard@solarcity.com FAX S'IEBFTADDEES5391 Foster City Blvd CITY, STA PE, ZIP Foster City, CA 94404 "650.477.6430 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME B-MAIL FAX STREETADDRESS CITY, STATE, ZIP PHONE USE or SFD or Duplex ❑ Multi -Family STRUCTURE' ❑ Commercial PROJECT IN WB.DLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT M FLOOD ZONE ❑ Yes ❑ NO /LAR PANELS 1 ❑ ELECTRICVRHICLECHARGINGSTATION ❑ SOLARWATERITEATNG ❑ OTHER: FORS0LRRANELS.• NUMBER OF PANELS/UMTS: 3I KILOWATTS (COMMERCIAL ONLY): D Qb TOTAL VALUATION] �/ 1 DESCRIPTION OF WORK Installation ( 1) rooftop flush mounted solar panel • 0(G) kW RPCPNED BY: By my signature below, I certify to each of the following: rathe pr9 owner or authorized agent to act on the properly owner's behalf. I have read this application and the information 1 have provided is correct. have read e Description of Worland verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constructs Yg�itDoPi representatives oFCupertino to enter the above-identifie<d7 propee y forrinspection purposes. Signature ofApplieant/Agent: (/ c' Date: 't .,L -� lG SUPPL TAL INFORMATION REQUIRED OFFICE USE ONLY Ww OVER-THE-COUNTER f❑ EXPRESS17 r STANDARD Uffp V � ❑ LARGE 5 ` El MAJOR E PVitpp 201 ].doe revised 03116111 CITY CUPERTINO FEE ESTIMATOR OF B BUILDING DIVISION MCI b, 6 �4 ialADDRESS: 22248 Hammond Way DATE: 02125/2016 REVIEWED BY: PAUL APN: 342 58 004 BP#: "VALUATION; 1$17,500 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION SOLAR -RE i USE: I PERMIT TYPE: WORK INSTALL N ROOFTOP MOUNTED SOLAR 8.06 KW - 31 PANELS SCOPE t :']. 1�h,v t irc'� e ur r. f hm Carek kit '. t (n t he�M1 . 'h, ilnr'dl he(r I ! }i1, f�8r P?Y /'e(C f if%S f (;(t t)Flhtl'dN,.'i 3. A.. f2 4M.'i'i [ ho,a) /tlti,»_ oiho �iS:C. ifmo tk' ±h lnv,� /we , 1 f)(q2 In"", I'e_, )"W Imp N"; NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nietrirt_ f1r.L Thv_ca fans are ha.eed on the nreliminary information available and are only an estimate. Contact the Dept for addn'l into. FEE ITEMS /Lee Resolution 11-053 Eft 7 J113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0,00 0 # $236.00 Alternative Energy System IPHOTOMES Photovoltaic System A Suppl. PC Fee: 0 Reg. ®OT 0.0 hrs $0.00 PME Plan Check $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. 0 OT F0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (. Exti,CZfat'ffUIIi lc'�. G) Work Without Permit? ® Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select allon-Residential Building or Structure G d 7'r atizl Pa<vumcnt f;�)n 1,e,,r. Strong Motion Fee: IBSEISMICR $2.28 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS:'1 $3.281 $236.001 TOTAL FEE $239.28 Revis d: 01/01/2016