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B-2017-0057 • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0057 18861 PENDERGAST AVE CUPERTINO,CA 95014-3620(375 33 026) WILLOW GLEN ELECTRIC INC SAN JOSE,CA 95155 OWNER'S NAME: KADARI SUDHARSHAN AND DAMERA MADHURI V DATE ISSUED:01/10/2017 OWNER'S PHONE:408-882-7675 PHONE NO:(408)289-9725 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic.#591918 Contractor WILLOW GLEN ELECTRIC INC Date 04/30/2018 X BLDG _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: (N)EV CHARGING STATION(50 AMP)-GARAGE I hereby affirm under penalty of perjury one of the following two declarations: 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 Pig Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Val ation:$940.00 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 APN Number: Oc pancy Type: and state laws relating to building construction,and hereby authorize 375 33 026 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 EXPI S IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DA SOF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cu ertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. l S gnature C l Date 01/10/2017 Issued by:Kim Dunbar Date:01/10/2017 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 p or to any roofing material being installed.If a roof is i. 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(Sec.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:01/10/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVE' 1 GS 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. HAZARD•US MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous aterials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safe Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with th•Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Se tion 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,shou d I use equipment or devices which emit hazardous air contaminants as defined.y the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance wi dl the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safe Code,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 1 APPLICANT CERTIFICATION Date:01/10/2017 I certify that I have read this application and state that the above information is CONS UCTION L i ING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is•:construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this per it 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 Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 01/10/2017 Professional (i sDiq--- Lc-L/4 0l (.46' AE1 / ; ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIOC\ ,�1,,, 10300 TORRE AVENUE•CUPERTINO,CA 950144255 CUPERTINO (408)777-3228•FAX(408)777-3333•builr3ir ra e,,Gi Iciais"�,at, —2O` • PROJECT ADDRESS my,% gpd - 7i f L71 6 (7 / ...7_ ( APN# 3 -76-: 33 ,02440 OWNER NAME/44m /e/ �' iYt PHONEa i r� 'r /ti! �EiIaMel ti..�.., ¢*F s s tax4,e17,44_, STREET ADDRESS ,(j0 09 i 1 Ale i Tgn ikiC) + 7: i4 FAX CONTACT NAME Mark Londre PHONE (408)289-9725 E-MAIL office@willowglenelectric.com STREET ADDRESS ry O, Box 8430 CITY,STATE,ZIP San Jose, CA 95155 FAX(408)289-9725 ❑OWNER 0 f OWNER-BUILDER 0 OWNER AGENT irCONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITEC" ❑ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME Mark Londre LICENSE NUMBER 591918 LICENSE TYPE C-10 BUS.LIC# 15897 COMPANY NAME Willow Glen Electric, Inc. E-MAIL office@wlllowglenelectric.com FAX (408)289-9725 STREET ADDRESS P. o. Box 8430 CITY.STATE,ZIP San Jose, CA 95155 PHONE (408)289-9725 ARCHITECT/ENGINEER NAME N/A LICENSE NUMBER `7 BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS/ CITY,STATE,ZIP PHONE USE OF 1I SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: 0 CommercialalURBAN INTERFACE AREA 0 Yes 0 No FLOOD ZONE 0 Yes 0 No ❑SOLAR PANELS ' ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS; KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATION ci DESCRIPTION OF WORK Electric Vehicle Charging Circuit: Fa-t2-.4)1 ` J ST7- L' i1 J V - .1- 7br REQBIV$A I3Y: 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 provided is correct. I hav re.d the I•scription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con h.', .,-, ° '•'yes of Cupertino to enter'the above-'d�entifiedf roperty for inspection purposes. Signature of Applicant/Agent: I '\\ Date: / T °" SUPPLEMENTAL INFORMATION REQUIRED OFFICE OSE ONLY 0 OVER-THE-COUNTER (C/I!l �jt/j1 (a)// g - ❑ EXPRESS- © STANDARD ❑:LARGE 0 MA7OR ' PVApp 2011.doc revised 03/16/11 niveiupe w: 0041 1vuu-0zsl,l,-4uuu-A4Uf-L;41-2649b26UD SMOKE/ CARBON MONOXIDE. ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3265 (408) 777-3228 - FAX (408) 777-3333 • bui(ding@eupertino.om- Permit No,g-2017-0057 Address 18861 Pendergast Avenue #of Alarms Smoke: 8 Carbon Monoxide: 1 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL TINS CERTIFICATE HAS BEEN SIONM AND RULENED TO THE BUILDING DIVISION PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314, 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 bedroom(s) X X 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 alarm's 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. Defer to CRC Section 8314 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: DocuSigned by: Madhuri Damera ...................... Contractor Name: 0020D78ED4A4420... Signature................................................................... Lic.##....-................................ pate:................... Smoke and C©fornr.doc revised 03118114 .7 DocuSign Envelope ID: 58471DOD-58CC-4DOD-A4C7-C4F2849B260D CUPERTIN116 N 1911,11 ii�i­lrl! I I', COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinq@cupertino.oLq OwnerNam, madhuri Damera Permit No. B-2017-0057 Address 18861 Pendergast Avenue, Cupertino, CA 95014 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 - 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site) F1 Yes Civil Code Sections 1101.1 through 1101.8 do, not apply. Sign below and skip the rest of the form. D uSi d by: 1/12/2017 Owner' Signature Date: D No Go to Question 2•E %.''r - 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? D Yes Civil Code Sections 1101.1 through 1101.8 do not apply. D The licensed plumber's certification has-been provided to the Building Division. Sign below and skip the rest of the form. DocuSigned by: Owner' Signature: 13 No Go to Question 3. E O..ilr Date:1/12/2017 I Is water service permanently disconnected for your building? E] yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature:DOCUSIgned by: Date: 1/12/2017 1:1 No Go to Question 4. E O%r 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 After January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. 11 Docuftned by: Owner' Signature: DA, %r Date: 1/12/2017 0 Yes My real property i WMn&DvxbbIc for use or occupancy on or before January 1, 11994 Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached. • 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 nuiltifanidy 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 2= , plumbing fixtures. SB407 2015.doe revised 02104115 7nvelope ID: 58471DOD-58CC-4DOD-A4C7-C4F2849B260D F On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- c as g---- plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). UWe, the owner(s) 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 110 1.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation reauirements. and that the water-conserair&tflima fixtures comely with the requirements as indicated in the table below. Owner's (or Owner Agent's) Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 1. if the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not requireu tv ve upgrauuu- SB407 2015.doc revised 02104115 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type yp Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallonstflush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. if the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not requireu tv ve upgrauuu- SB407 2015.doc revised 02104115 Install one 240 Volt 50 Amp dedicated circuit with a NEMA 14-50 receptacle behind the main panel in the front right corner of the garage for EV charging. This circuit will provide 40 continuous amps for charging. Depending on the construction of the wall, the new NEMA 14-50 receptacle will be either surface or flush -mounted. House COtdIMI)NITY DRTI. 71 7KIT DEPAnTMENT BUILDING DIMS" it - i.UPERTINO No rot of r1nn s enr! ?,.'•[!ST h^ !-"t � t the ob L! 'k : (.'R N' r0nG'0cJ-)il. 16 I• ilii i1C11`.:I to r17,•.. any GiF�i Ni O ,:.I .t:r:.t; ), .,, oin or to thorolfow, w•iti io;ut a;, -ruval from tho BuildIng Oi fGlal. Tho 0,mr!nn of th13 p!!,, ? .onO ^itic,.Alom SHA .L. P Q -r 'i1:311:'to i` C,e•'tii�Uf't4.,.`l J1,,.I(33frE.-: alta-:it3n of any provi`cion., of any Gi-',y or :sic:; w" Law. I r^>.-cswc-=�a� •- s-^"..'. —_ • �,�z.-.-,-m::-.��»�r.�s��-z�Msic.s...,er.:.-.� DAT E PERMIT NO. Madhuri Damera Page t Madhuri Damera 18861 Pendergast Avenue Cupertino, CA. 95014 (408) 882-7675 _ CUPERTINO Building Depa*nent a, JAN 0 9 213V REVIEWED FOR CQ Ll uT G D: VV C Reviewed BY: A FIP This aar of p6ans wid apedficati2ar[a site ¢: wing consilucfloni R is unlawft from the Building I'm stare aii't„ r,af tine, hflaan air iZQQQAih i anf,,rI, W/ 3FiA`d I� BY ATE i Garner N lca vf., 6/3 Romex (Nj NEMA 14-50 Receptacle (N Driveway M MENT DEPARTMENT N -.. a U 11:'rvhu' TM WED ft1TT be; kept at tlie+ jci.i to inaaae any chraiinges or afrom, wiffincat approval caboiis SI-IAI I. I140T I'aa aT the: vfalcatian or ai y , 7F tKata; M..6avv^',. Residential Electrical load Calculation Site Location: Prepared by 1 L L O W Madhuri Damera Willow Glen Electric, Inc. M1 %,I 61N 18861 Pendergast Avenue PO Bax 8430 L 8 C T R I C Cupertino, CA. 95014 San Jose, CA 95155 4 (408) 882-7675 (408) 289-9725 -office General Lighting and Receptacle Loads [220.12] 3 watts per ft' x 2,173 - 6,519 Small -Appliance Branch Circuits 1220.52(A), 210.1(C)(1)] 1,50D watts x 2 = 3,000 Laundry Branch Cireuit(S) [220.52(8), [210.11(0)(2)] 1,500 watts x 1 - 1,500 11,019 Fastened -In -Place Appliances Kitchen Bath(s) outisde/Miscellaneous [220.531 Refrigerators) = 780 Instant HotH2O(s) = Exhaust Farl = Hot Tub = Dishwasher(s) = 960 Hood Exhaust(s) = Jacuzzi Tub(s) = Pool Equipment = Garbage Disposals) = 600 Gas Range(s) = Radiant Heating = Central Vacuum = Microwave(s) = 1,200 Gas Oven(s) = Steam shower = Sewage Ejector = Trash Compactor = Wine Fridge(s) = Sauna = BDA Circuit = Steamer = _ = Garden Shed = Total Fastened -in-place Appliance Load 3,540 Clothes Dryer(s)[220,541 80% x 240 x Derating Volts Amps 1,200 OR Name Plate Rating of Clothes Dryer = 1,200 Ranges, Ovens, Cooktops, and Other Household Cooking Appliances (220.551 80% x 240 x - 1,200 Derating Volts Amps AND / OR Name Plate Rating of Cooking Appliances = 1,200 Heating or Air -Conditioning System (Compare the heat and A/C, and omit the smaller.) [220.60] Air Handler/Furnace 115 x 6.0 = Volts Amps Alr Candltianars 7,290 55% x 240 x 50 = Derating Volts AND/ OR Name Plate Rating of Air Handler & AC Units = Tota[ Volt -Ampere Demand Load [220.83[ Greater of. Air-condltlaningEquipment 7,290 x i0D% = 7,290 Electric Space Heating - x 10D',6 _ First SkVA of all other loads 8,000 x 100°' = 8,000 Remainder of all other loads 8,959 x 44% = 3,594 18,874 Total Current Minimum Amperes 18,874 _ 240 = 78,6 Current Minimum 200 Amps (voltage) (minimum amperes) 17 Size Service or Feeder [240.6(A)) currently ElaCtriC Vehicle [625.14] 125% x 244 x 40 = 12,000 continuous Load Volts Amps Minimum Amperes with Added Load Minimum Size Divide the total 30,874 = 240 = 128.6 20 Service or Feeder 200 Amps volt-amperes by (voltage) (minimum amperes) wf Added Load with added load the voltage. i240.6(A)l NOTES All References are to 2014 National Electrical Code. NSTALLING YOUR 240 VOLT OUTLET The recommended home charging installation for Tesla vehicles Is a 240 volt NEMA 14- 50 outlet. This outlet Is commonly used for electric ranges and large reoreational vehicles. Installed with a 60 -amp circuit breaker, this cutlet enables a recharge rate of about 26 miles per hour. Consult a licensed electrlolan to review the electrical load of your home prior to Installation, They will design your charging system and obtain a permit for a general purpose NEMA 1+50 outlet from your iocal building department. After Installation, the electrician will schedule an Inspection to approve the new electrical circuit and design. This guide provides reference for specifications to Install this outlet. Since eanh Installation Is custom to the home, all hardware for the NEMA 14.54 outlet will be provided by your electrician. GROUND TO TOP NEMA 14-50 DETAILS • Voltage: Single phase, 208.260 volt AC supply, 60 hertz • Circuit Breaker: 50 amp (1259/9 overourrent protection) • Operating Current: 40 amp (maximum continuous current) • Conductors: 6 AWG, Copper Wire Only. Upsize wlring for installations over 160 feet • Ground Fault Circuit Interrupter: Not required • Service Disconnect.' Not required • Receptacle Recommendation. High quality, industrial grade receptacle Examples: Hubbell part ## H3L940A, Cooper part #5754N • Ventilation: Not required • Outdoors: Install with NEMA 3R rainproof enclosure RECOMMENDED LOCATIONS G, 4ARCaL PORT RECOMMENDED L.00NrION FOP U0 VOIJ (ai.r7l..i f ADDITIONAL RESOURCES EMAIL Cl lAr G[NCIN STALI-A'1'ION(91TF-SLA.COM PHONE 650,681.613:5 (M --F:) 24/7 TECH SUPPORT 377798.37 52 WEB fE SL.A,COM/SAJI'L 1P R'l ONLINE STOKE T = 5 t" R 45500 Fremont Boulevard, Fremont, CA 94538 1 May, 2010 1 Version 3