B-2017-1581 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1581
21020 RAINBOW DR CUPERTINO,CA 95014-5210(366 26 038) SLINGSHOT POWER
INC
LOS ALTOS,CA 94022
OWNER'S NAME: DATE ISSUED:09/14/2017
OWNER'S PHONE: PHONE NO:(650)308-9055
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-46 Lic.#984488
Contractor SLINGSHOT POWER INC Date 06/30/2019 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) 16-PANEL ROOF MOUNTED PV SYSTEM(5.28 KW)
1 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 •
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:$18480.00
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: Occupancy Type:
and state laws relating to building construction,and hereby authorize 366 26 038
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 Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatu �/ Date 09-14-2017 Issued by:Kim Dunbar
Date:09/14/2017
OWN +°-BUILDER DECLARATION
•
I hereby affirm that I ant 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)
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:09-14-2017
•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
permit is issued. maintain compliance with the 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,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,becoine subject to the Worker's Compensation provisions of the the Health&Safety Code, 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:! ; �. �
APPLICANT CERTIFICATION Date:09-14-2017
I certify that I have read this application and state that the above information is CONST• '" TION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and 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 expensed 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. I understand my plans shall be used as public records.
Licensed
Signature Date 09-14-2017 Professional
\ / ALTERNATIVE ENERGY PERMIT APPLICATION
/' COMMUNITY DEVELOPMENT DEPARTMENT••BUILDING DIVISION
�S,,.o,„ 10300 TORRE AVENUE CUPERTINO, CA 95014-3255
CUPERTINO (408)7.77-3228•FAX(408)777-3333•buildinq(a.cupertino.orq `
1, 20 11 - / sg I
PROJECT ADDRESS i APN#3 r„ (to - 03 Q,
21020 Rainbow Drive .•, t�J coLL/ `t' O
OWNER NAME Rajiv Maheshwary PHONE 650 278 7277 ,E-MAIL rajivmaheshwary@yahoo.com
STREET ADDRESS 21020 Rainbow Drive CITY, STATE,ZIP FAX
Cupertino,Ca 95014
CONTACT NAME PHONE E-MAIL,
Linda Dodge 669 213 9211 Ldodge@slingshotpower.com
STREET ADDRESS 164 Main Street CITY,STATE,ZIPFAX 650. 887 0345
Los Altos CA 94022
❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTRACTOR XCONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME LICENSE NUMBER LICFGN4S6E TYPE , , LBM 8r 126 (g
Ravi Chiruvolu 984488 ``F !!1`f�l 1 `/ �b
COMPANY NAME E-MAIL FAX
Slingshot Power I�ccDc9 t f GDDc'+Ji'mi- / 650 887 0345
STREET ADDRESS CITY,STATE,ZIP Los Altos,CA 94022 PHONE
164 Main Street 650 209 0171
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF 7 SFD or Duplex v _Multi-Family PROJECT IN WILDLAND PROJECT IN
STRUCTURE: Y❑'Commercial URBAN INTERFACE AREA 0 Yes Zi\.
NO FLOOD ZONE 0 Yes No
iSSOLAR PANELS 0 ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER:
FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: I f KILOWATTS(COMMERCIAL ONLY): EP''•i J t�,v, AT{J i J n 'Q'
I(o •l:1 `� ?S(J
DESCRIPTION OF WORK4--
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By mysignature 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 Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws rel.w. _to,;,uilding co ction. authorize representatives of Cupertino to enter bove entifi p erty for inspection purposes.
_ '
Signature of Applicant/Age&O q'/ , Q v P Dat l ,)i (SUPPLEMENTAL INFORMATION REQUIREDOFFICE USE ONLY
^ • :0 OVER THE-COUNTER
•
�" ❑ EXPRESS
8 ❑ STANDARD
afi .. ,0 °LARGE
t 0 MAJOR
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I PVApp 2011.doc revised 03/16/11
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SMOKE / CARBON MONOXIDE.ALARMS
CI OWNER CERTIFICATE OF COMPLIANCE
Ds COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
•
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228 •FAX(408)777-3333•buildinq(a.cupertino.orq '
PERMIT.CANNOT BE FINALED UNTIL THIS:CERTIFICATE HAS BEEN,
COMPLETED,.SIGNED,.ANDRETURNED-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 R314, 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 Alarmsbe installed in the following locations:
AREA SMOKE ALARM CO ALARM
' Outside of each separate sleeping area in the immediate vicinity of the X X
bedroom(s)-(Smoke alarms shall not be.located within 3 feet of bathroom door)
On every level'of a dwelling.unit'including basements and habitable attics X X
YVithin;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)maybe 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.
Address: ,2. 1 a 2 o RP Vj f 3 d,,./ DK"1 Vl-; (AA Ifc7t 1 l Wa (4 S-6 lit Permit No. 201-7
Specify Number of Alarms: #Smoke Alarms: J 3 I #Carbon Monoxide Detectors: J 3 I
!have read and agree to comply withthe terms and conditions of this statement
Owner(or Owner Agent's)Name:M/1V
kg IV 'l1. Ef�(wy�i,2Signature (-) .) , (� Date: g/t'�i(/�, q.
'� \ .�./.?'.��.� I
ontracctor Name: 7) �
J h
It i 1:7 Gf2 Signature(�/
Smoke and COform.doc revised 01/10/2017
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