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B-2017-2127 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR. PERMIT NO:B-2017-2127 1343 PRIMROSE WAY CUPERTINO,CA 95014-5229(366 17 045) BRIGHT PLANET SOLAR INC AUBURN,MA 01581 OWNER'S NAME. YING YEESHUN S AND SUSAN S DATE ISSUED•12/12/2017 OWNER'S PHONE.408-318-7187 PHONE NO:(888)997-4469 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO• License Class C-10 Lic.#1020761 Contractor BRIGHT PLANET SOLAR INC Date 11/30/2018 X BLDG _ELECT _PLUMB MECIT X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION (N)8-PANEL ROOF MOUNTED PV SYSTEM(3.19 KW) I hereby affirm under penalty of perjury one of the following two declarations: 1. 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. 01,2. 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:$12760.00. 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 ordinances APN Number. Occupancy Type: and state laws relating to building construction,and hereby authorize 366 17 045 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue againstsaidCity in stands andce of the hg othis 'WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulationsperthe Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION SignatureOgA S p Date 12/12/2017 Issued by Abby Ayende Date: 12/12/2017 OWNER-BUILDER DECLARATION I hereby affirm that I ant exempt from the Contractor's License Law for one of the RE-ROOFS. following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:12/12/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. -Owner or authorized agent: IAA Oki APPLICANT CERTIFICATION Date: 12/12/2017 (J I certify that I have.read this application and state that the above information is CONSTRUCTION LENDIM AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097 Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 12/12/2017 Professional CONSTRUCTION PERMIT APPLICATION t COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION. 10300 TORRE AVENUE • CUPERTINO,CA 95014-325.5 01.4,4 (408)777-3226 • building@cupertino.org PENIIT gF- CCUPERTINL7 REV; ILEI ❑ NEW CON5I'RUC IoN 0 ADDITION ❑ALTERATION ❑TI. ❑11S p. ❑RE-ROOF ❑SWIMMING POOL/SPA —. PROJECT ADDRESS 1 APN e A°^ t r—O4 OWNER NAME I 1410NE L..iviAlE STREET ADDRESS ( 1 i�." r urn 1 C[TY.5Tc1T1,:,f SiY „4-+I t d 4 ( \.»», i t Li 1111 1-• CONTRACTOR NAME CIOw ER-BUILDER COMPANYNAME LICENS NUMBER LICENSE TYPE E(11-44..)f-±b _ r1 . ' .. `alar 1 , S'TREETADDRESS a CI'I'i'°,STATE, ".?CP E-MAIL I PHONE BUS.LIC= t iCt oftiLi -(10 0i f,i LiK, t . JA'rYI o9 rt 2,10 03 Og5C 0 ARCHITECT El OWNER II OWN R AGENT 0 CONTRACTOR AGENT0 ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAME E-MAIL._.. STREET ADDRESS CITY,STATE,ZIP PHONE DECRIPTON t fl t a 1. 1 c Y 't c .c gt3g4fIn 11ifUo4100A ©S1NCLE-FAtvilLY/DUPLEY 0MOLTT:FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING 5F 1 NEW FLOOR SF PORCH SF DECK SF DEMOSF STORIES« TOE AI,NIT 5Fs USE 'IYl E OCC •Q.I X, VALUATION{4 REMODEL REMODEL KITCHEN REMODELOTHR GARAGE 0 ATt'AC»EEG BATHROOM.SF SF SF SF' 0 DETACHED EKt5ING ❑Yt s EIC FILGII ❑YES SECOND STORY ADDITION0 YEs FIRE SPRINKLERS 0 NO ® NO 0 NO DWELLING SECOND DWELLING 0 yEs 0 ATTACHED°DETACHED OTHER IJNrrs t UNIT ADDITOEm. 0 NO SF POOL$I 0 FIBERGLASS ®vr,TYL•LINED 0 GUT;ITE 0 PREFAIIRICATIID I POOL-SF SPA-SE ( SPA ATTACHED . YIS 0:^Do 1 TOTAL.-SF I RE DIVED BY: y TOTAL V.A1 JATION: Cer,werctai or Multi-Fa»ty l)tadarrtg;with PUItc$toi,5nth Pols revues Deparwmentof Etuirnnntental Heath approval '2 i4, ll& RE-ROOF EXE STING ROOF TYPE: O BUILT-UP ROOF D ASPHALT SHINIGLESD WOOL/SIMMS Q WOOD SHINGLES Dm,< OTH TER(SPECLE•Y) REMOVE/REPLACED NO IF NO PLYWOOD 0 0 3/8" PLYWOOD TYPE; I'ITCEE POOP'CLASS DYES G OF LAYERS_ THICKNESS S .El 5/S" OTHER . . Doss 0 CDX' OTHER -- –° L A PROPOSED ROOF TYPE:DBUILT•t!PROOF DASPHALTSHINGLES:0w0O66SHAKES Dwool)SHINGLES 0OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF Sof SQUARES By my signature below I certify to each of the following: I an the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Worm and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. I acknowledge and authorize all information contained on this application form to be made available for public" •,. • a Signature of Applicant/Agent Wri 414111 Date: _ t 2--(("" ri SUPPLEMENTAL INFORMATION REQUIRED 'New SFD.Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction; * Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. 'HOA-Provide a leiter of approval from the Home Owner's Association • BIdgApp_2017.doc revised 0&OLI17 _.... JA Vg-i&V\