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15040108-DP10320 FARALLONE DR 15040108 F/P YONGMING ZHANG SCANNED BOX #663 _ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10320 FARALLONE DR CONTRACTOR: SOLARCITY PERMIT NO: 15040108 OWNER'S NAME: YONGMING ZHANG 3055 CLEARVIEW WAY DATE ISSUED: 04/15/2015 OWNER'S PHONE: 4095061556 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL INSTALL 12 PV MODULES 3.12 KW n License Class �� (U y_C N � �' � 0 L� ��'�f/"to Contractor ,^ I hereby atl;rfn hat I am licensed under the provisions of Chapter 9 (commencif 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. Sq. Ft Floor Area: Valuation: $7000 /n 1 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36930012.00 Occupancy Type; 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D S OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, against said City in consequence of r� 4/ I 7 costs, and expenses which may a true Issued by: Date: `� granting of this permit, Additio filly, tl applicant understands and will comply with all non -point source regu tions r the Cupertino Municipal Code, Section RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is 9.18. Date Signature __ installed without first obtaining an inspection, I agree to remove all new materials for inspection, t' ❑ OWNER -BUILDER DECLARATION Signature of Applicant Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 IIAZARDOUS MATERIALS DISCLOSURE construct the project (Sce.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material, Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area A1'''f Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertinov`u)r pal Code, Chapter 9.12 and 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 tf Health & S h he eaSafety Code, Sections 25505, 2� 33,{ ad 25534. Owner or authorized agent: V' Date: permit is issued I certify that in the performance of the work for which this permit is issued, I shall ---7 v not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and stale 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit Additionally, the applicant understands and will comply with all non -paint source regulations per the Cupertino Municipal Code, Section Licensed Professional 9,18, Signature Date CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION f`� COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 1 \l� AF 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 / (408) 777-3228 • FAX (408) 777-3333 • building(c)cuoertino.mg `(�� PROJECT ADDRESS 72 7 �+ n 1� Y.. APE -3/_�1 `7 3 U r- 0' ( OWNERNAME Chris �Q.h PHONE {0 , R-MAIL STREETADDRESS/q�p py I]f� V OvV r V V CI,J,YTATE, ZI C.- e, - �. 5 o I PAX CONTACT NAME Marjan Javanmard PHONE 650.477.6430 1 EMAIL mjavanmard@solarcity.com STREETADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR IN CONTRACTOR AGENT ❑ ARCHITECT El ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME SolarClty Corporation LICENSENUMBER 888104 LICENSE TYPE C 10 BUS. LICB2UUOOAO OO VV COMPANYNAME SolarCity Corporation E-MAIL mjjaOvOanmard@solarcity.com FAX STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PHGNE650.477.6430 ARCHITECT/ENGINEER NAME LICENSENUMBER BUS. LICk COMPANY NAM E MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRICTURE: ❑ Commercial PROJECT IN WIIDLAND URBAN IN'1'L+RFACE AREA ❑ Yes ❑ No PROJECTIN FLOODZONE ❑ Yes ❑ NO SOLAR PANELS ❑ ELECTRICVEHICLECHARGING STATION ❑ SOLAR WATER HEADO ❑ OTHER: y W 1, rORSOLARPANELS, NUMBEROFPANELS/ONITS: KILOWATTS (COMMERCIAL ONLY): TOTALVALUATION: DESCRIPTION OF WORK Installation (jL) rooftop flush mounted solar panel kW By my signature below, I certify to each of the following: I am the�,,PP operty ner or authorized agent to act on [h owner's behalf. I have read this application and the information I have provided is correct. I havej" 11- cription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction, ai tfi riisesseentatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicmt/Agent /"�t/f' Date: o e( / 1 5 15 SUPPLE -�A,INFORMATION REQUIRED OFFICE, USE ONLY ❑ OVER-THE-COUNTER ppp, F ❑ EXPRESS ❑ STANDARD V ❑ LARGE M ❑ MAJOR PYApp_2011. doc revised 03116111 CITY OF CUPERTINO r� FF.F. FCTIMATOR — RITII,DING DIVISION 10320 FARALLONE DR DATE: 04115 2015 REVIEWED BY: MELISSA W1ADDRESS: APN: 369 30 012 BP#: VALUATION: $7,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex p PENTAMATION SOLAR-RES PERMIT TYPE: USE: INSTALL 12 PV MODULES 3.12 KW [WORK E :t-tech. Plan C'hech I I 11''lurrth. Ivan (:heck I I I Elea. Plana C'hea/, %fecF 1'em?i Pee: Phonb. Permit Pew: Flee, Permoii 1"Ve: Usher, ch. lrrsp. Or&,, P11.... b fn..r/a 8)ther Eke. Insp, Meet,. Insp. lee: 111w,ib. Insp, Fee: Llec..insP_ I ee: NOTFr This estimate does not include fees due to other Departments (1.a Planning, Public Works, Fire, Sanitary Sewer District, School L......1 ,... a. ,. ......I: ».:»......:»F «»,..fn» nvonn6/o aaAnro anti) an acnmote. t antaet me Uent top aaan't into. FEE ITEMS (Fee Resolution 11-053 Eff. 7111132 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F 1 # $236.00 Alternative Energy System IPHOTOVREs I Photovoltaic System Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C'onsirurtion Rzv rtdminiTtralive iFoe,: Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure qy Dyzvel Locuirientaflo l.Fees: Strong Motion Fee: IBSEISMICR $0.91 Select an Administrative Item Bldg StdsCommission Fee: IBCBSC $1.00 :6UBTOTALS:' $1.91 $236.00 TOTAL FEE;: $237.91 Revised: 04101/2015