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15100113CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6733 CLIFFORD DR CONTRACTOR: SANTA CRUZ WESTSIDE PERMIT NO: 15100113 ELECTRIC OWNER'S NAME: SANJEEV SAHNI 2119 DELAWARE AVE DATE ISSUED: 10/14/2015 OWNER'S PHONE: 4082422154 SANTA CRUZ, CA 95060 PHONE NO: (831) 469-8888 ®-- LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL 14 ROOF TOP, FLUSH MOUNTED PV MODULES (4.2 License Class 1 c Lie. 9 2_ K 1 Contractor 5.4 ; E rtpe Date r gg 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. Sq. Ft Floor Area: Valuation: $14700 I hereby affirm under penalty of perjury one of the following two declarations: 1. 1 have and will maintain a certificate of consent to self -insure for Worker's APN Number: 36911044.00 Occupancy Type: Compensation, as provided for by Section 3700 of the Labor Code, for the of the work for which this permit is issued. k.1performance 2. 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 permit is issued. PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is 1 CALLED INSPECTION.. 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 ate: fll upon the above mentioned property for inspection purposes. (We) agree to save su 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 RE -ROOFS: all non -point source regu ationsper Cupertino Municipal Code, Secti n 9.18. �i All roofs shall be inspected prior to any roofing material being installed. If a roof is inspection,,I to remove all new materials for SignatureDate/n,9 s r installed without first obtaining an agree � inspection. Signature of Applicant: Date: ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: t. I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIALS DISCLOSURE compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the 2. 1, as owner of the property, am exclusively contracting with licensed contractors to California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & construct the project (Sec.7044, Business & Professions Code). Safety Code, Section 25532(a) should I store or handle hazardous material. I hereby affirm under penalty of perjury one of the following three declarations: Additionally; should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will 1. I have and will maintain a Certificate of Consent to self -insure for Worker's maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Compensation, as provided for by Section 3700 of the Labor Code, for the Health & Safety Code, Sections 25505, 25533, and 25534. performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by the work for which this Owner a .t `ar d a t: i Date: L/X//� Section 3700 of the Labor Code, for the performance of permit is issued. s. I certify that in the performance of the work for which this permit is issued, I shall CONSTRUCTION LENDING AGENCY not employ any person in any manner so as to become subject to the Worker's I hereby affirm that there is a construction lending agency for the performance of work's Compensation laws of California. If, after making this certificate of exemption, I for which this permit is issued (Sec. 3097, Civ C.) become subject to the Worker's Compensation provisions of the Labor Code, I Lender's Name must forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Address APPLICANT CERTIFICATION ARCHITECT'S DECLARATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional 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 ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 AE CI, PERTItslo j (408) 777-3228 • FAX (408) 777-3333 • buildingiMcupettino.om —7—APNY._O PROJEC:TADDRESS 6733 Clifford Drive L OWNER NAME Sanjeev Sahni PHONE 7 408-242-2154 L• :MAIL STREET ADDRESS CITY, STATE, ZIP FAX 6733 Clifford Drive Cupertino, Ca 95014 CONTACT NAME. L� ILSTREET tIITIP1121F� ADDRESS �'^� ZIP 112 (C t)i.;'N};R ❑ OWNrit-BUILDER ❑ OWNER, AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHri-ECT ❑ ENGINEER ❑ DEVEt.OPF.R ❑ TENANT C O TR..gTOR AIME tCF.NSE NUMBEILICE3l5r TYPE BUS: LIC r ry C.O\dPANY vA\t£ E-MAIL P " CAQ0 �y 5' STREET ADD1tESS 5. 21 } C1T'Y, STATE, Z]P; C CJNF. PH •) Livl ARCHITECUENGINEER NAM£L10E.NSE NUN BF1i SUS. LICK COMPANY NAME E-NIALL � FAX STREET ADDRESS ,/' CITY, STATE ZIP1 �,. PHONE USE OF X SFD or Duplex ❑ Multi -Fancily PROJECT IN WILDLAND PROJECL'IN -1TRt.iCTURE: ❑ C:orrlrttercial URBANINTERFACE .AREA ❑. Yes ❑ NO FLOODZONE ❑ Yes 0 NO +OL:1 R PAN£LS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WAT11 HEATING. ❑ OTHER: _ FOR:SOt..IR PRNrL.X NUNIBER GF PANELSIUNITS: KILOWATTS LY): y . Z ,r()TAL VAL 1JAT3G N: 4 14,700 `P tJE'SC'RIPT'1C7N OF WORK` Installation of a 4.2kw grid tied photovoltaic solar array roof mount. r3 13y my signature below, t certify to each of the following! 1 am the property owner or authorized agent to act on the pr mees 1 have Tea his application and the information t have provided is correct. have read the Description of Work and verily it is accurate_ i agree t ply with all appy le local ordinances and state laws relating to b�lildi g can ruct' . I ala " Drize representatives ofCupertino to enter the above:identif property fbr i Ion purposes. SigratureofApplicant/Agent: ' � Date: 10/14/15 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY D os�R.r�Lr<.cotrraT�R � ❑ EXPRESS Y r 5 :STANDARD - G ❑ LARGE 7 El mAjoit PI App_2011.doc revised 113.%141'11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 6733 CLIFFORD DR TDATE: 10/14/2015 REVIEWED BY: MELISSA APN: 369 11 044 BP#: *VALUATION: $14,700 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: SOLAR -RES WORK INSTALL 14 ROOF TOP FLUSH MOUNTED PV MODULES 4.2 SCOPE 1vul h 1 his esumare aoes not incivae fees uue to uenei "ci,u. 911MI.— I.... � 4 •....•b, - - -- - - - - - District, etc.. These ees are based on the preliminary information available and are only an estimate. Contact the Dept/or addn'l 1 FEE ITEMS Resolution 11-053 Eff. 711/131 FEE QTY/FEE MISC ITEMS i ICC6t..�jjf li [ !7G'�k 1j � .11i42�:. Plan t? i-'lF2L'�C I:i[%C'. Pict ("he; k :'1'tet:tF. Ijersratl e. k rt�,Mli. .psi:r!1!cF Ff.'e. .t:.t.. C._. I t.r lit lt Fee. Oft F �Zet lt..1T2�' CJ4 z T`1�(U 2??-tFiSf?, i 1&r Elec. Tnsp. El ;Afech. hi: p. Fee: I'1x:rr1T. ItarT. poet Elec. insp Pee: Permit Fee: Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 Ti':..n Qn-i —t Rawar nictrirt. School 1vul h 1 his esumare aoes not incivae fees uue to uenei "ci,u. 911MI.— I.... � 4 •....•b, - - -- - - - - - District, etc.. These ees are based on the preliminary information available and are only an estimate. Contact the Dept/or addn'l 1 FEE ITEMS Resolution 11-053 Eff. 711/131 FEE QTY/FEE MISC ITEMS ,Lee Plan Check Fee: $0.00 I ' # Alternative Energy System $236.00 IPHOTOVRES Photovoltaic System Suppl. PC Fee: Reg. 0 OTT70.70:hrs $0.00 $0.00 PME Plan Check: Permit Fee: Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 $0.00 PME Unit Fee: $0.00 $0.00-- 0.00(.'onstr PME Permit Fee: ( lonstruc Lion Tai:: 4dnfit7isPrathre t''ee: Work Without Permit? O Yes (F) No $0.00 $0.00 Select a Non -Residential Building or Structure Select an Administrative Item Advanced Planning Fee:. Travel 1. oc'Zif"1'ien x1,017 .aF'e'e.5': $1.91 Strong Motion Fee: IBSEISMICR Bldg Stds Commission Fee: 1BCBSC $1.00 UBt7ITALs $2.91 $236.00 TOTAL FES. $238.91 Revised: 10/0112015 V 0 ir, 'gl Iq :8 1"''s '�D 1, , T Z COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 5 k4V51I f f-JZ40 - rAA j10131 " 7-3333 - puildinq�c_vcppertino.orp 16 ( OD 6733 Clifford Dr, Cupertino, CA 95014 Address ft of Alarnis Snioke: CarllorNlonoxlde: PFR';\11TCAN\-,0'1'I1V'. FI NNAI-E D AND COMITEI I':€3 L'N I Il, TI I IS CER H HCAIL PURPOSE `Ulnas f' is a self-ccrtifical on f to ti compliance ivith 2013 CRC Section 8314, 2013 C13C Sections 20,6 and 907.1-11.2 there no interioraccess for inspections are required. GENERAL INFORMATION E\istina,0 single-famfly and. multi -family dweltings shall be provided with Smoke Alarms and Carbon, Monoxidealarnis, When the valuation of additions, alterations, or repairs to existing cicvelling units exceedc, $1000-00, CRC Section R314 and CBC Sections 9117,2.11.5 and 420.6 reqLlit-Q that Smoke Alarms and/or Ca.r.boll Monoxide Alan -ns be installed in the following locations: AREA SMOKE ALARM Outside of eachseparatesleeping area inthe iminedia.1te Vicinity offfie s x On every level of a dweltin, Within each sleepine rooni x CO ALAWN-1 x Carbon :Monoxide alarms are not required in divellings which do not contain f-uel-burning ,-ippliaiizes,-tr.ti that do not have an attached garage. Carbon monoxidealarms combined with smoke alarms shall comph, avitll CBC Section 420.6 and shall be approved b%, the Office of the State Fire Marsha]. F'ower Supply: h -i d%reffin.g units,,vith no con-unercial power supply, alarni(s) may be solely battery operated, In existing dwelling units, alarms are permitted to be solely battery operated Where repairs oralterations do not result. in flie removal of wall and ceiling finishes or there is no access by means of attic, basement or craivi space. Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required Foi Malar ms which rnu.4 be connected to the building Nviring. I As owner of the above -referenced property, I hcrf:'by certify that the llarin(s) ha "�Jlave loc""11 installed in accordance with the manufacturer's iws'tructfons and in compliance with tho Cdif(WIlist BL(j1diT11" -tnd California Residential Codes.The alarms have been tested and are operational, as of the dite sioned belov-,-- I hAve rand and acre: tel airnolv vvith fherfns o! this Ow -*r (9,, Ovofer Agent's) Name* Sanjeev Sahni t iZ t i ` .. ........ Date Ccinvador Name: Sandbar Solar $iqratur ....... Date: of SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFIcxm OF COMPLIANCE CUPERTINO qVROD3 PURPOSE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building (d.cupertino.org ,I 0--Z �5 151=6 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN S CN , AND RF,TURNFD TO THE BUILDING DIVISION i 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 $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. 111 existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. t have read and agree to comply with the terms and conditions of this statement Qv�r+or ent-s),-Nam ($ Ha are....................................................................................................... ....f,DatQ� .....�...3 .� Co�p_efotvN�ame: _ k. SI na are ..................................... ............................ i�L c,��................................. � ..... .. Smoke and CO form.doc remised 03/18/14 CUPERTINO 'WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 � FIL�= Pas 15, Owner Name A �N J_eE\77-322 FAaC �Q$)�777-3333 building(a s /`j�`� ��/ cupertinY-orqermit No. � 1 �� Address 0_ p i 3 � C -OF �� � � . ( er / f kiop CA Osy i 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. io 0- No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 'ANO Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Ig C'rYes My real property is built and available for use -or occupancy on or before January 1, 1994. Civil Code Sections'1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Ple e check ONE of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1-101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether propeity undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the following nage. FZ, 1 9 n Owner or Owner Agent's Sig Upon completing and signing this Certificate, please return it to the Building Division in order to final your building SB407 2015.doc revised 08/26115 w V 'o 0 0 Qo (D z a� 0 LU 'o U) ir :) 0' :u z < MWU6FW - U, z z 0 z /No 2p aQ Lu zCi U) ul ::S Z Z 0 0 Sop, 0 C)!S< al'o LU w w 0 0 0' El El 0 z > z w cr wo Ck z w w 25 Z p z 2 z 0 >O z W w x uj z w co Z z 403 0 o W W W rk c _j UJ 0 > ua < 5w 0 C z z UWU X w joy CL . 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