B-2016-2006 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2006
7540 HEATHERWOOD DR CUPERTINO,CA 95014-5841 (359 28 044) ALTERNATIVE
ENERGY INC
WINDSOR,CA 95492
OWNER'S NAME: SAMMANNA SATISH AND SHREE BIIARGHAVI DATE ISSUED:05/24/2016
OWNER'S PHONE:4088355690 PHONE NO:(213)673-1515
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=10 Lie.#862625
Contractor ALTERNATIVE ENERGY INC Date 07/31/2017 X BLDG X ELECT _PLUMB
MECH X RESIDENTIAL_COD/IMERCIAL
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)16 PANEL ROOF-MOUNTED PV SYSTEM(5.52 KW);(N)SUB-
I hereby affirm under penalty of perjury one of the following two declarations: PANEL(100 AMPS)-SIDE YARD
t. 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.
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:$26450.00
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 59 Number: Occupancy Type:
359
and state laws relating to building construction,and hereby authorize 3 28 044
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 against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per th ertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 05/24/2016 Issued by:PAUL O'SULLIVAN
Date:05/24/2016
OWNER-BUILDS DECLARATION
I hereby affirm that I am 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
t. 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(Sce.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:05/24/2016
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
s. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)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 0 25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agen .�
APPLICANT CERTIFICATION Date:05/24/2016
1 certify that I have read this application and state that the above information is ,ONSTR J CTION ,sNDTI tEN Y
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 05/24/2016 Professional
ALTERNATIVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE o CI PERTINO, CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•building cupertino.org
PROJECT ADDRESS . APN#
OWNER NAME Satish Sammanna PHONE 408-835-5690 1 E-MAIL Sammanna@gmail.com
STREET ADDRESS 7540 Heatherwood Drive CITY, STATE,ZIP Cupertino,CA 95014 FAX
CONTACT NAME PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
DOWNER [I OWNER-BUILDER [3 OWNER AGENT ❑CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑DEVELOPER []TENANT
CONTRACTOR NAME Alternative Energy Inc. LICENSENUMBER Yjb2�pZ LICENSE TYPE C-10 BUS.LIC,#i
coMPANYNAME Alternative Energy Inc. E-MAIL cfiye@alternativeenergyinc.com FAx 213-342-7795
STREET ADDRESS 5405 Wilshire Blvd.Suite 335 CITY,STATE,zip Los Angeles,CA,90036 PHONE 213-673-1515
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN
URBAN INTERFACE AREA ❑ Yes ❑No FLOOD ZONE ❑ Yes ❑No
❑SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION I ❑ SOLAR WATER HEATING ❑ OTHER: Q
FOR SOLAR PANELS: NUMBER OF PANELSIUNITS: 16 KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATION:$26,450
DESCRIPTION OF WORK Rooftop solar.PV installation
RECEIVED BY
WL
By my signature below,I certify to each of the following:I am the property owner or authorized agent to.act on the property owner's behalf.I have read this
application and the information I have provie .I ave read the Description of Work and verify it is accurate.I agree to comply with all applicable local
ordinances and state laws relatin u ding cons ctio authorize representatives of Cupertino to enter the above-iden'fled prop /for inspection purposes.
Signature of Applicant/Agent: Date: 2 b
SUPPLEMENTAL INFORMATION REQUIRED oFFicE USE ONLY
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PVApp 2011.doc revised 03/16/11
DocuSign Envelope ID:5676D521-58D9-4186-AEE0-285E116B98F6
SMOKE / CARBON MONOXIDE ALARMS I L E
I'a OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
CU ERT NO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(a)cupertino.org
B-2016-2006
7540 Heatherwood Drive Cupertino, CA 95014 Permit No.
Address #of Alarms Smoke: Carbon Monoxide:
����,�P�RNIIT cA�vo�l�E�� aLEn Alva I~AMPLETED uIVTIL�THIS cERT�ICaTE
= k 66
AS Bj :.a RFTt) � IVISN �'
PURPOSE
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 X X
bedroom(s)
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.
In 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.
I have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name: 000usignea by:
Satish Sammanna S , �awtwtaantnol 6/8/2016
Signature. .......... Date: ................
Contractor Name: 3A39DGECB4924B6...
Signature...................................................................Lic.#......................................Date: ...................
Smoke and CO form.doe revised 03118114
DocuSign Envelope ID:5676D521-58D9-4186-AEEO-285E116B98F6
WATER-CONSERVING PLUMBING FIXTURES FILE
19 OWNER CERTIFICATE OF COMPLIANCE16
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION (3e-bf
CUPEFi"1"INO 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
sati sh samr 19&777-3228•FAX(408)777-3333•build inq(CDcupertino.om B-2016-2006
Owner Name Permit No
Address 7540 Heatherwood Drive Cupertino, CA 95014
1. Is your real property a registered historical site? -
El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
❑ b 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.
N� 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.
Ifid No Go to Question 4.
4. Is your real propprV 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..
NE] Yes 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. Please check ONE of the following:
as 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 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).
❑ 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 page. Docus 9nea by:
Owner or Owner Agent's Signature: SDate:
Upon completing and signing this eFeWft`�Ieffe return it to the Building Division in order to final your building permit.
SB4072015.doe revised 08126115