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B-2016-2140 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR PERMIT NO:B-2016-2140 10146 MANN DR CUPERTINO,CA 95014-1138(326 19 007) WEST COAST SOLAR INC BRENTWOOD,CA 94513 OWNER'S NAME: RYDER MARK E TRUSTEE DATE ISSUED:06/15/2016 OWNER'S PHONE:408-257-3961 PHONE NO:,(925)516-3900 LICENSED CONTRACT'OR'S DECLARATION BUELDING PERMIT INFO: License Class C-39,C-46 Lic.#908549 Contractor WEST COAST SOLAR INC Date 12/31/2017 X BLDG X ELECT _PLUMB MECH X RESIDENTIAL—COMMERCIAL 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: (I)24-PANEL ROOF-MOUNTED PV SYSTEM(6.24W);(I)SUB- I hereby affirm under penalty of perjury one of the following two declarations: PANEL(125 AMP) 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. 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:$24000.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 19 007 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. Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT _�SUANCE OR source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAS/T D IN;PECTION. Signature' Date6/1512016 Issued by:Alex Vallelunea Date:06/15/2016 OWNER-BU"FRDECLI 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 installed t i. I,as owner of the property,or my employees with wages as their sole nstaewithout 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(See.7044,Business&Professions Code). Date:6/15/2016 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued,I 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 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. -� Owner orauthortzed agent: APPLICANT CERTIFICATION Date:6/15/201 I certify that I have read this application and state that the above information is TR N E A N Y correct.1 agree to comply with all city and county ordinances and state laws I hereby affirm that there 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 ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 6/15/2016 Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 CUPETTtNo (408)777-3228•FAX(408)777-3333•building cI elapertino.oM maUjLo - i •! PROJECT ADDRESS " APN U 1 OWNER NAME F.. PHONE E-MAIL _ STREET ADDRESS STATE„ZIP ? FFE ., '.t`s'si, CONTACT NAME PHONE ...EMAIL �.t 1 ,r�to4.i� .�. ,'.��/�`-rYt3/t) `. .t'•%� `wL�'”s' ..��" �,E'�'� (.,G'i�7' STREET ADDRESS CIT STATE,ZIP FAX OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR W CONTRACTOR AGENT ❑+ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LIC /�,ENSE NUMBER _ LICENSE TYPE BUS.LIC# lJ/ ^'�> COMPANY NAME E M. I. .. _ F STREET DDRESS CITY,STAT,ZIP PHONE 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 1 STRUCTURE: ❑' Commercial - URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO IOLARPANELS. _ ❑ ELECTRIC VEHICLE CHARGING STATION FO SOLAR WATER HEATING ❑ OTHER: j FOR SOLAR PANELS, NUMBER OF PANELS/UNITS KILOWATTS(COMMERCIAL ONLY) TOTAL VALUATION, ) }� /t b / 7 (�{ L,! DESCRIPTION OF WORK _ R y „. `. 442 _ 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'oehalf I have read this application and the information I have 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 laws relating to building c struction. I authorize representatives of Cupertino to enter the above-identified property*for inspection purposes. Signature of Applicant/Agent: R. Date: SWIPIEMEN INFORMATION REQUIRED G p i�XPIZta�s II`1JOLt PVApp_2011.doe revised 03116111 Fps i�AL 1� SMOKE /CARBON MONOXIDE ALARMS IL OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CiJPERTNNO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228 FAX(408)777-3333•building(cDcupertino.ora , � Permit No. _ ( C) Address +-0 0�r✓P V� QA_� #of Alarms 'Smoke: Carbon Mono de: PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE "fit{ HAS BEEN hUQNp.AND RF IRNFD TO THE B' IING DM- SIGN s 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 a cess for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbo 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 COALARM 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 comf ily 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 Aerated. 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,basemen L 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 beconnected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has ave 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 co)vpiy with the tem;kanw conditions of this statement Owner(or Owner Agent's)Name: ffII . Signature....... .. .. ( ...... ................... ........:.D e: . .... ..d..... Contractor Name: Sinature...................................................................Lic.#......................................Da te: ................... Smoke and CO form.doc ri vised 03118114 FILE LlajWATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPEBTI O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 417 8)777-3228•FAX(408)777-3333•building cupertino.org A _2-o(6 Owner Name IM 1 411 Permit No. Address lr'� 0/� f 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 f rm. o 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 ii s 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? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. o Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1,1994? El No My real property is built and available for use or occupancy afterJanuary 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). 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 Cade 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 wat corse pl ing fixtures comply with the requirements as indicated in the table on the followingpage. Owner or Owner Agent's Signature: a Date: - fisedi08126115 Upon completing and signing this Certifica please re it to the Building Division in order to final your buildint. SB4072015.doc