08040076CITY• OF CUPERTINO-
BUILDING DIVISION PERAUT
BUILDING ADDRESS:
22285 S DE ANZA CL
RENEWABLE POWER SOLUTIONS
PERMIT NO.
08040076
NER'S NAME:
PERMIT ISSUE DATE
MARSHALL MAPLE
1190 S BASCOM AVE STE 211
04/25/2008
PHONE:
SANITARY NO. CONTROL NO.
(408) 998-7400
ARCHITECT/ENGINEER:
-
BUILDING PERMff INTO
BLDG ELECT PLUMB MECH
O O O O
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm Nn 1 w licensed ander provisions of Chapter 9 (commencing
Job Description
wife Section 701M0 of DiWsion 3 of Me throens and Coca. Coca. annd my license is
RF MOUNT SOLAR PHOTOVOLTAIC SYS,NO BATTERIES
In full fare. ad
end eff4 eca� v
License Lic. N 2afiR50S d
��JCI
_
Dam ContractoraCj;Rld
ARCHf1EC1•S DECLARATION
I understand my plans Nall be used as public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby aRren that 1 em eaempt from Me Con"Cutes License Law for the
following reason. (Section 7031.5: Business and Pmfesuom Cade: Any City or county
which acquires a Permit to construct, elan Improve, demolish, nr repair any structure
Prior W its issuance, atm mquirm tie applicant fm such Permit to file aligned statemant
Mel he is licensed punuenOo the provisions of Me Connector's License Law (Chapter 9
Sq. Ft. Floor AreaValuation
(commencing with Section 7000) of Division 3 of Me Business and Profession. Coca) or
2 5 0 0 0
$25000
that he is esampt Meac(mm and the basis for Me alleged exemption. Any vlaiad'on of
Section 7011.5 by airy applicant far a permit rvbjecb the applManl to a civil penalty of
� Number
Occupancy Type
not mom Man loss hundred dollen ($500).
35602030,
❑ 1. u owrmr of the property, ar my employee, with wagas as chair sole eampenmuan.
will do the work, and Me smseture Is and intended oroffered for sale(see7W. Business
sand Pmfeas(am Cade: Tim Canaactor's License LAW door Ml apply he N awns of
Required Inspections
property who builds m improves theacan, and who dna such work himself m Mmugh his
own employee; Provided Met such improwmenu art not intended aroRered forme. if..
however. Me budding or Impmwsomm is mid within oro your of,eceplauon. the mover.
builder will have Me burden of proving dost M did not chid improve: or improfor purpose of
7u owner of elm ProPertY• am exclusively convening with BxneW mnuxtors to
couatmct Me project (Sec. 7094, Business and Profaaions Cada:) The C.Mmtor's V-
an= Law dors not pply to an owner of property who holds or improw t Merton, and
-
who contracts for such Projects with acome ctor(U licensed pursuant to Me Conuacoure,
License Law.
...
❑ I am except Under J .BdPCfar Mu n
rev . Data
�RB q ATION DECLARATION--C�
�b}^afRirfG
1 Ent-uYnf+/ndei penalty of perjury oro of Ne fallowing deck ndom:
❑ I have and will maintain a CeNficateur CammntMxlf-Insurtforwmicompen-
xtion, as provided for by Section 3700 of Me Labor Code, for Me performance of Me
work fm which this permit is issued.
❑ I have and will maintain Worker's Compensation Imorma, m required by Section
17M of Me labor Code. far the performance of Me work for which Mis permit is lerued.
'
My Worker's Computations Inman main and Policy number am:
Carder. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
,
(Thu xnian reed not uncompleted If the permit is two= handed dollars ($100)
or lora)
I unify Met in Mc perform.. of Me wark for which this permit is issu,0.1 all not
employ any person in my n armsstobecomc rvbjecr to Men ll�rken" nsatian
Laws of Cagfo i Dat
Applicant
NOTICE TO APPLICANT: If, aN eking this niB o q you should
became subject be the Worker's Compensation For -
or-foMwiM.mply
forthwith complywith such Provisions or this pem d that] M decreed rewked,
CONSIAUCf10N LENDING AGENCY
1 lamby alfmn Mad Mort is a construction lending agency for the performance of
Me work for which dust permit is issmd (Sea. 3039, Civ. C.)
Lender's Name
'
undoes Address
I certify that I have rad this application and sum that Me, show informetiun is
correct. l agree to comply with all city and county oNimanxs and sate laws misting M
building comsnowdon, end hereby authorise representatives of this city to enter upon Me
shove-menuanetl property for inspection puryoxg
(We) agree to now, indemnify and gasp hermleu'Me City of Cupertino against
and insinuation which may in any way accrue agaimtsald City
litin
casiva,judg of the
in eomegusxe of Me grancng of Nis permit.
APPLICANT UNDERSTAN WILL COMPLY WITH ALLN PO
Issued by: Date "Z.IP=iza
SOURCEREGU S.
�
Re -roofs
'/%%
/L/
Omf
StgnmuHAZARDOUS
MATERIALSDISCLOSURE
Type of Roof
Will the .,pit., of future building acupanl port or handle hassudous material
as deduced by Me, Catamarca Manuel Code. Chapter 9AZ and Me Had and Safety
de.
Section 35532(.)7
❑Yea o
All roofs shall be inspected prior to any roofing material being installed.
WIII the
If a roof is installed without first obtaininginspection, I agree to remove
an ins P g
applicant or forum building occupant tax tyuipmcnl w devices which
emit hmstdous air comaminanm as dcuned by Me Bay Area Air Quality Management
all new materials for inspection.
District?
❑Ya Nu
I haw mat the hamdeusmamnau acquirements umkr Chapmr6.95 of the Califor.
nu Health S,S f tyCado Scetiom25505.25533 and25534. I undemand Mtiifthc building
does not cameo y haw a t It u my mspe ouldlity M notify Me occas t of
raqulremcnu w' re 'or M issuance of a Certificate aro ca Q5 D
Signature of Applicant Date
roof coverings to be Class '%?" or better
autha' Data'All
V