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15110037-DCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10295 PARKSIDE LN CONTRACTOR: SANTA CRUZ WESTSIDE PERMIT NO: 151 10037 ELECTRIC OWNER'S NAME:'TAO JEFF AND SUNG -MIN 2119 DELAWARE AVE DATE ISSUED: 1 1106/2015 OWNER'S PHONE : :A087785531 SANTA CRUZ, CA 95060 PHONE NO: (831) 469 -8888 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class" `: ` "'� u''i ic. Install (18) rooftop flush mounted solar panels (5.4 KW) Contractor . :' •• ' Date I hereby affirm that I ain licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and'ithnt'my licensees in full force and effect. I hereby affirm�'under peualty'bf perjury one of the following two declarations: 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 Sq. Ft Floor Area: Valuation: $18900 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 bf the Labor Code, for the performance of the work for which this " APN Number: 36904022.00 Occupancy Type: 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 DAYS 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 FROM LAST CALLED INSPECTION. indemnify and keep Harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the O granting of this'permit: Additionally, the applicant understands and will comply Issued b • Vv` Date: Y' with all non- point;source regulations per the Cupertino Municipal Code, Section RE- ROOFS: 9.18:., „r •,,.,..,;:;';..,,..;:. Signature r f�zli(if ' . ! Date f / All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for :.. ,. inspection. ❑ 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: � ,; ' i • ` I, as owner of the'property, ormy employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER will do the work;'and'the :s".cfure is'not intended or offered for sale (Sec.7044, Business'& Profe'ssions;Code).' .: . I, as owner of the,property, arr► ekclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the projeci (Sec,7.044, 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. I 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: 'I ^,,;i , ;r,i a is ' di 'maintain'a Certificate Consent insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous I have andw' of to self - material. Additionally, should I use equipment or devices which emit hazardous Compensation, '.is provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for; which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 1 have and will maintain Workers Compensation Insurance, as provided for by v Section; 3,700 of the''Labor Code,jfor the performance of the work for which this the Health &Safety Code, Sections 25505, 2 33, a d 25534. N_ '• 4 ;, ii.: .. permit is issued.rl' Owner or authorized agent: Date: l % rforance of the work for which this permit is issued, I shall I certify that in the pem not employ any person in'any manner so as to become subject to the Worker's Compensation laws of California. If after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Workers Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith coniply`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 Lender's Address ? APPLICANT CERTIFICATION 1 certify that 1 have.read this; application and state that the above information is correct`,Lagree"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 indemnify and,keephamiless.the City of Cupertino against liabilities, judgments, ARCHI'TECT'S DECLARATION costs! 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- pomt,source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature ,' "� k' : k :: , l Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10295 PARKSIDE LN CONTRACTOR: PERMIT NO: 151 10037 C S er'—f SO /G /^ 1 t OWNER'S NAME: TAO JEFF AND SUNG -MIN 355 Pa w6la -bvx FW 944 DATE ISSUED: 11/06/2015 OWNER'S PHONE: 4087185531 (P llP� , (/I PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ /� ��// ?uw `7t/ INSTALL(18)ROOFTOP FLUSH MOUNTED SOLAR License Class 1'] Lie. # PANELS(5.4 PsPr�� ?^ a - lS -lS KW) Contractor rC• Date 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. I hereby affirm under penalty of perjury one ofthe 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 ofthe Labor Code, for the Sq. Ft Floor Area: Valuation: $18900 performance ofthe work for which this permit is issued. 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 APN Number: 36904022.00 Occupancy Type: 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. 1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 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 CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of th granting of this permit. Additionally, the applicant understands and will comply y: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 'l�^ any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER - BUILDER DFCL,ARATION 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 1, as owner ofthe 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.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. I 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 ofthe Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District performance ofthe work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 ofthe Labor Code, for the performance of the work for which this Owner Dater permit is issued. or authorized agent: I certify that in the performance ofthe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions ofthe 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 state 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence ofthe I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signatute Date COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE o CUPERTINO, CA 95014 -3255 CUPERTItdO (408) 777 -3228 • FAX (408) 777 -3333 • buildingecupertino.oril U4 PROJECT ADDRESS 10295 Parkside Lane I APN# "5 o - 22 OWNER NAME Sun -Min Tao PHONE 408 -718 -5531 E -MAIL STREET ADDRESS 10295 Parkside Lane CITY, STATE, ZIP Cu ertino Ca 95014 FAX CONTACT NAME Kristi Cassetta PHONE 831-226-9363 E -MAIL kcassetta @sandbarsc.com STREET ADDRESS 2119 Delaware Avenue CITY , STATE, ZIP Santa Cruz Ca 95060 FAX 831 - 515 -5098 ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT y� id CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT C'ONIRACTOR NAME Sandbar LICENSE NUMBER 462 4 LICENSE TYPE -10 BUS. LIC # 33925 S)antMPAa NY AM G�ruz E Westside Electric dba Sandbar E -MAIL kcassetta sandbarsc.com FAX 831 - 515 -5098 .STREET ADDRESS Avenue Santa Cruz Ca 95060 PHONE 31- 469 -8888 ARCHITECT /ENGINEER NAME Sungevity LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL Sam - sholing @sungevity.com FAX STREET ADDRESS 66 Franklin Street Ste. 310 CITY, STATE, ZIP Oakland CA 94607 PHONE USE OF ill SFD or Duplex ❑ Multi- Family PROJECT IN WTLDLAND PROJECT IN STRUCTURE: ❑ Commercial },/, URBAN INTERFACE AREA ❑ Yes No N FLOOD ZONE ❑ Yes ❑ No 16 SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION 1 ❑ SOLAR WATER HEATING ❑ OTHER: T'ORS0111 R PA NELS; NUMBER OF PANELS /UNITS: j / KILOWATTKO 'ER LON�.Y): r (�l J TOTAL VALUATION: $1p 9OO O DESCRIPTION OF WORK ' Installation of a 5.4kw grid tied photovoltaic solar array roof mount �RECE ED BY By my signature below, I certify t the fol wing: I am the property owner or authorized agent to act on the property owner's behalf. I hav d this application and the information ave ovi is orr ct. I ha v ead the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel ng to b ilding c n ion. orize representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of ApplicandAge Date: X116/15 LEMENTAL INFORMATION REQUIREDoFF tcE USE ONLY " OVER -THF COUNTER .'fM ❑r�EXPRESS ❑ STANDARD z „ �' _ ❑ LARGE - - ❑ ` MAJOR' PVApp_2011.doc revised 03 116111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 10295 Parkside Lane DATE: 11/0612015 REVIEWED BY: Phuong APN: 369 -04 -022 BP #: *VALUATION: 1$18,900 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 0.0 PENTAMATION SOLAR -RES PERMIT TYPE: WORK Install 18 rooftop flush mounted solar panels 5.4 K SCOPE ;l teE;:1. 1' la i C"!"ie ck i�:�•'r. 1rt:J. 1��e 11; "heck Fill NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.): 1 heselees are basea on the preitmtnary tnjormatton avattante ana are only an esumate. contact the wept jor aaan -t tnJo. FEE ITEMS (Fee Resolution 11 -053 Eft 7/U133 FEE QTY /FEE I MISC ITEMS Plan Check Fee: $0.00 = # $236.00 Alternative Energy System 1PHOTOVRES Photovoltaic System Suppl. PC Fee: Reg. C) OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure "i OVei litt<;umeeaanion Fees: Strom Motion Fee: 1BSEISMICR $2.46 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 E� �F K,tsUBTOTALS $3.46 $236.00 TOTAL FEE $239.46 Revised: 10/01/2015 S�SFINMMF IM SOLAR License #846294 December 8, 2015 City of Cupertino 10300 Torre Ave. Cupertino, CA 95014 To Whom it May Concern, Sandbar is requesting a transfer of permit #15110037 for the installation of a new photovoltaic system located at 10295 Parkside Ln. to the following contractor: Desert Solar, Inc. (dba Energy Solutions) license #942290. If you have any questions or concerns, please contact me directly at (831) 469 -8888. Regards, Alicia Moss ai-noss@sandbarsc.com (831) 469 -8888 2119 Delaware Ave. Santa Cruz California 95060 Phone: 831.469.8888 Fax: 831.515.5098 ` ON cli C13 Q uj IL r LLI C) CD LL ROOF 00 MQ w co z ca LL F— 0 F: r —60 al wm it < Q. 0 0 W7 0 0, IL 0 wo z i m W w z x c z z 0 M;z z < I-- V) w S? z a� U) 0 D D Z) w L2 E 0 F- C cv w w 0 C:) o _0 C) (n Ld > qty LU ui 10 < 1. 0 m Z. lw < 0 > z m --i . . F - r > 0 D 0 < z 30: 2E 1 3: 1. w - F6 z 2 f�- 0 < 2 u < t; 0 g) 'z 0 <z zz 0 z >x 2 z o u tv 0 0 D in- -Z2 0 Zz z b '-u z o 2 <- Z lo :,D ES 0 60 z 0 u o z 6 IF, 'n Z Cz, u o L4 o Q 0 3: 0 2 0 a < z QJ < u Z < (D F- Z. 0 2 z < 0 < z u 0 z z 0 p 0 Q, OZ ❑ T b < ti 0 � Z o m W 00 < < < 12, z 0 L9 z m 0 X U W Z 1 :1 - Z r3 ^ D z Fa �i D ❑< m 3 0 0 - u Ci �- M Cf 0 < X 0 ❑ �2 2 :E 1 - . u z �� 0 0 z co U z -Z 8- . in R 0 0 1 ;WC 0 ml 19 3: t7, w >° 7 Z. 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