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B-2017-0835CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0835 10642 RANDY IN CUPERTINO, CA 95014-2055 (316 02 066) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: DEO VIVEK AND REWATI OWNER'S PHONE: 408-649-0909 LICENSED CONTRACTOR'S DECLARATION License Class C-10 Lic. #888104 Contractor SOLARCITY CORPORATION Date 12/31/2018 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 of the following two declarations: 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. 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. SignatureDate 05-25-2017 ISSUED: 05/25/2017 PHONE NO: (650) 963-5100 BUILDING PERMIT INFO: X BLDG X ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (I) 21 PANELS ROOF MOUNTED PV SYSTEM (6.82KW); (I) SUB - PANEL (200 AMP); (1) BATTERY BACK-UP Sq. Ft Floor Area: I Valuation: $22000.00 APN Number: Occupancy Type: 316 02 066 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 05/25/2017 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 1. 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) z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 2. 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. 3. 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 Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature, Date 05-25-2017 Signature ofAppl Date: 05-25-2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, S 'ons 25505, 25533, and 25534. Owner or authorized agent: Date: 05-25-2017 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building 05-cuperiino.org 35 PROJECT ADDRESS 06� 14"p 7 OWNER NAME PHONE tI M�rA f"fN ✓of selc5C&O STREET ADDRESS /lA.`P"N �# Y� CSTATE,23P GFAX f SE / ' CONTACT NAME Gerry Igtanloc PHONE 650-759-8042 E-MAILgigtanloc@solarcity.com STREET ADD' 391 Foster City Blvd. CITY, STATE, ZIP Foster City,CA,944041 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELAPER ❑ TENANT CONTRACTOR NAME SolarCity Corp. LICENSENUMBER888104 LICENSE TIREC10,C46 I BUS. LIC #28844 COMPANY NAMESolarCity Corp. E-MAIL gigtanloc@solarcity.com FAx STREETADDRESs3055 Clearview Way CrTY,STATE, ZIP San Mateo, CA 94402 PHONE650-759-8042 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LTC # COMPANY NAME E-MAIL f FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF FD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT IN FLOOD ZONE ❑ Yes ❑ No J�rSOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION TOSOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OFPANELS/UMTS: % KILOWATTS (COMMERCIAL ONLY): ( TOTAL VALUATION:. � „ Q� 00 DESCRIPTION OF WORK Install (Z. f ) rooftop mounted solar panels,( KW �— v 4 E -r', Itl --5V s "- P REc $ 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 have read the Descriptio of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ng construction. IIaa�uthori3kiepresentatl s of Cupertino to enter the above -i ntified p perty for inspection purposes. Signature of Applicant/Agent: -- —� Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY ❑ OVEWTM—COUNTER ❑ EXPRESS ❑ STANDARD a ❑ LARGE ❑ MAJOR PYApp 201 Ldoc revised 03/16/11 CCL -4.- P VApp CLQ CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0835 10642 RANDY IN CUPERTINO, CA 95014-2055 (316 02 066) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: DEO VIVEK AND REWATI OWNER'S PHONE: 408-649-0909 LICENSED CONTRACTOR'S DECLARATION License Class ROOFING Lic. #888104 Contractor SOLARCITY CORPORATION Date 12/31/2018 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 of the following two declarations: 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 -9 �Frformance 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. 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulafon per the Cupertino uni pal Code, Section 9.18. Signature Date 7/13/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the 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) z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 2. 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. 3. 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 Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date 7/13/2017 DATE ISSUED: 05/25/2017 PHONE NO: (650) 963-5100 BUILDING PERMIT INFO: BLDG X ELECT _ PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (N) 21 PANELS ROOF MOUNTED PV SYSTEM (6.82KW); (1) SUB - PANEL (200 AMP); (1) BATTERY BACK-UP REV #1 - REMOVE SUBPANEL (200 AMP)- ISSUED 7/13/2017 Sq. Ft Floor Area: l Valuation: $22000.00 APN Number: Occupancy Type: 316 02 066 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ABBY AYENDE Date: 05/25/2017 RF ROOFS: All roofs sball 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. Signature ofApl Date:17/ 3/2017 ALL ROOF COVERINGS TO BE CLASS "A" HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cu ertino 'opal Cod@, Chapter 9.12 and the Health & Safety Co. d7eetio 25505, 25533, and 25534. Owner or authorized agent: Date: 7/13/2017J CONSTRIICTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO ?p 0� 3!�s ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org 'I PROJECT ADDRESS ILq& j_CrAPN # OWNERNAME L) PHONE Lm,4qqrO`©j\(tw E-MAILl`�/� J � %FiAXSTREET ADDRESS/�j �{ j� f1 CITY, STATE,ZIP/7v/OLQ i� -L.I� i,' CONTACT NAME PHONE C / `J ('L STREET ADDRESS '• % CITYi STATF QIP C /�` ❑ OWNER ❑ OWNER -BUILDER ❑JOWNERAGENT CONTRACTOR ❑ CONTTRA�CTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME I E-MAIL FAX STREET ADDRESS I CITY, STATE, ZIP I PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS I CITY, STATE, ZIP I PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family PROJECT IN 1VILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO ❑ SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: DESCRTPTION OF WORK By my signature below, I certify to each oM/ e following: I am the property owner or authorized agent to act on the property owner's befial£ I h1ve read this application and the information I have pfp4ided is cpayect. 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 toding onstructtiiondI authorize representatives of Cupertino to enter the above -id yntified o)perty for inspection purposes. Signature ofApplicant/. ? ._�� J — Date: T �lJ AL INFORMATION REQUIRED PVApp_2011.doc revised 03/16111 LA-. CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingaacupertino.ora PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED, SIGNED, -AND _RETURNED 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 2016 CRC Section 8314, R315, 2016 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, R315, 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) - (Smoke alarms shall not be located within 3 feet of bathroom door) X X On every level of a dwelling unit including basements and habitable attics 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 specified below have been tested and are operational, as of the date signed below. VO �_� Address: Permit No. Specify Number of Alarms: # Smoke Alarms: F-711 # Carbon Monoxide Detectors: 1 have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: IW 0 Sinature .............. ............................................................................................. Date:..�....�..s.. Contractor Name: Signature...................................................................... Licl........................................ Date:................... 17 Smoke and CO form.doc revised 0111012017 CUPERTINO Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a.cupertino.org Permit No. — Address I �'7'�� RAO W 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 fon-n. Z No Go to Question 2. � a 3 � r —? r 2. Does your real properly 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 fo�rman� i.gn bottom of form. 1{ No Go to Question 3. U` --L _ 3. Is water service permanently disconnected for your building? 02105-1 n ❑ ,Yes Civil Code Sections 110ough 1101.8 do not apply. Skip the rest of the form and sign bottom of fonn. ;r3 No Go to Question 4. 4. Is your real property 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. l Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of fonn. /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..�� Please check ONE of the following: D V all 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 coniniercial 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 nage. I Owner or Owner Agent's Signature: Date: _ Upon completing and signing this Certificate, please return it to the Building Division in order to final your building p Term SB4072015.doc revised 01/05117