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B-2016-2863 CUPERTINO (408)777-3228•FAX(408)777-3333•buildincAcupertinO.Org PERMIT CANNOT BE YLNALED€TNTIL THIS CERTIFICATE g S;E E ::, _;..;,. Gp1VIl�IETED,jSCf17.NEI?,.ANI RF3N ; I`x©THEIIIIITG } C? T �v �3�ry p�q 1 CJR1 VSE. This-affidavit is a-self-certi- ication-for the installationofall required Smoke and Carbo t Monoxide Alarms for compliance with 2013 CRC Section R314,2013 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 X X the bedroon (s) On every level of a dwelling unit including basements X X Within eachsleeping room 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 alaarms.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 electrkai 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 alarms)referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with'the California Building - _ �operational,.as of the and California Residential Codes.The alarms.specified- have been.estecl an-d-a date signed below. �_j'1 r! 1 ' 4 cade.T fi P i la :o c--014-1R4-414 Permit No. r No;--3 Address: �C��� ,—"�3 4 Carbon Monoxide Detectors: Specify Number cif Alarms: m Smoke Alarms:� � -_ I have read and agree to comply with the terms and conattions ofthis$'catemenf / Jd�t� Owner(or Owner Agent's)Name: Date:l'z#Sl''i Signature_... Contractor Name: Lica Date:Signature . Srnto4. and CO farni.dr,revised 09'27 /6 Ili t WATER-CONSERVING- PLUMBING FMTURES RE ' OWNER CERTIFICATE OF COMPLIANCE ;�z,' COMMUNITY DEVELOPMENT DEPARTME +.- NT-BUILDING DIVISION UERTilti! 10300 TORRE AVENUE CUPERTTNO,CA 95014-3255 (408)777-3228 s FAX(408)777-3333•buildinoOcuaterfirtoorq pp//_ Owner Name AR. A L .T I_ Permit N �.. 6 W/i " SCC Address IOki$ ,3i.`ti ,PEtZ Ce€ 4.7 , CUfc2. ,'4o , C }L- R)le•A 0. 4 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1-through 1101.8 do riot apply. Skip the rest of the form and sign bottom of form. $,,,No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of e property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to IbeBuilding Division. Skip the rest of die form and sign bottom of foam. , X No Go to Question 3. 3. Is water service permanently disconnected for your building? apply. sign bottom of form. G1 Yes Civil Code Sections 1101.1 throughIIOL8 do not a 1 . S " the rest ofthe form and ' No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? Q 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. 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: 0 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- shallbereplaced- with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). i Cl My property is a multifamily r e idea tiaLrea1 roper See Civil Code Section 1101.5, On and after January I,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). Cl My property is a commercial read property. See Civil Code Section 1101.5. Orr and afterJamrary 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 ofwhether property undergoes alterations or improvements). 1,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_plumbingfixtures in accordance withCiviLCode.Sections_110-1.1 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 on the following page: , t �Y' 1M-,a-' f t- Date:. i %-6,, OUtablemer or OwaerAgen#'s Signature: Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. .0407 20154oc revised 081.16115