B-2016-2046 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2046
7559 NORMANDY WAY CUPERTINO,CA 95014-5222(366 11 154) SKYWAY ELECTRIC
SAN JOSE,CA 95113
OWNER'S NAME: SALTER STUART M AND MARILYN F TRUSTEE DATE ISSUED:05/31/2016
OWNER'S PHONE:408-257-9008 PHONE NO:(408)418-4607
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=10 Lic.#387957
Contractor SKYWAY ELECTRIC Date 03/31/2018 X BLDG X ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
(N)14-PANEL ROOF-MOUNTED PV SYSTEM(3.92 kW);(1)MAIN
I hereby affirm under penalty of perjury one of the following two declarations: PANEL(200 AMPS)-OUTSIDE
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.
z. I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Cade,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$13000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
information is correct.1 agree to comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 366 11 154
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 regu tions per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAS CAL D PECTION.
Signature Date 5/31/2016 Issued by:Alex Vallelunea
Date:05/31/2016
OWNER-BUILDER 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
r. I,as owner of the propert34 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)
z. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:5/31/2016
1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 1 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
z. 1 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. 1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. 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&Safe , ,Sections 25505,25533,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:5/31/2016
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances land 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. 1 understand my plans shall be used as public records.
Licensed
Signature Date 5/31/2016 Professional
I
.........__..... .
ALTERNA I IVE ENERGY PERMIT APPLICATION
COMMUNITY DEVELOPf LENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•ICUPERTINO,CA 95014-3255
CUPERTIN® (408)777-3228•FAX(408)777-3333•building(o-cupertino.org
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PROJECT ADR SS APN#
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STREETADDRESS �Jy�(fr `i f / / CITY, STATE,ZIP/)._ __lino /^� �®/ FAX
CONTACT NAME ! r_ `• vv PHONE E-MAIL!
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STREET ADDRESS !a__/ �/ CIT STAR, P FAX
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❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT C0`TRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ,❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME�j ✓� /��G LICENSE NUMBER r LICENSETYPEBUS.LIC#
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COMPANY NAME E-MAIL FAX
STREET ADDRESS J CITY,STATE,ZIP J r / PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF FD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN
STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ NO FLOOD ZONE ❑ Yes ❑ NO
SOLAR PANELS [ E] ELECTRIC VEHICLE CHARGING TATION ❑ SOLAR WATERHEATING ❑ OTHER:
FOR SOLAR PANELS. NUMBER OOF�PANELSIUNITS: / KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATION:/S f, '
DESCRIPTION OF WORK c G> 2-k / P r O
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RECEIVEb BY ,�
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By my signature below,I certify to ach of the following: I am the property owner or authorized agent to act on the property owner's beh 1. I have read this
application and the information I ha a provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state'law building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Dater
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
OVER-THE-COUNTER
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AWOKE I CARBON JUNIOXIDEALAARMS
S ER : E"FjCA; '
COM MUNITY+DEVELOPMENT':DEPARTMENT,BUILDING DIVISION
U .�, 10300 TORRE AVENUE•GUP'ERTINO,CA 95014-3255
(408)777-3228-FAX(408.)777-3333► build n,ciRcupertino oro
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.
GENPPAlJ 110ORMATION
Existing single-family and inulti-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 8314 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:
AR&A SMOKE AtlE4 C0 ALAR
Outside of each separate sleeping area in the immediate vicinity of the X
bedrooms)
On every level of a dwelfin unit including basements X
X
Within each sleeping room
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that
do not Have am 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 Eire Marshal.
Power Supply: In dwelling-ut lits with no commercial power supply,alarm(s)may be solely battery operated.
In exi=sting dwelling units;alarrms are permitted tob-e solely battery operated where repairs or alterations-do
not result in the removal of wall and ceiliiag finishes or there is nu access by means of attic;base-meet or crawl
space..Refer to CRC Section 8314 and CBC Sections,907.2.11.4 and 420.6.2.An electrical permit is required for
alarms:wl1ich must be connected too the building wiring.
As owner of the above-referenced property,I hereby certify that the alarin(s) referenced above has/have been
installed in accordance with the ;��ainufacturer s instructions and in compliance with the Califor<n a Build n&
a
anal Califomia Residential Codes,The alarrns•Dave been tested; and are,operational,a.s•of the date sighed
below.
i haue dead and a r 1; with the teems conditions of this statement
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WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
'COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING'DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228 FAX(408)777-3333•buildingPcupertino.org '_wMti
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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.
L--J-'K' 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?
El 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.
No Go to Question 3.
3. Is water service permanently disconnected for your building?
0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
r—, No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
0 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.
, 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;
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).
1,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 thatth a e-cons ' fi
g plumbxtures comply with the requirements as indicated in the
table on the followingpage.
Owner or Owner Agent's Sig natufre
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB4072015.doc revised 08126115