B-2016-1416 SMOKE/WATER - ,F .> ►UAKMV =�MUNUXIDE ALAARMS ,
OWNER CERTIFICATE OF COMPLIANCE'
COMMUNITY DEVELOPMENT DEPARTMENT m BUILDING DIVISION L E
rCtllPi in 1Na 10300 TORRE AVENUE®CUPERTINO,CA 95014-3255 .
(408)777-3228 a FAX(408)777-3333 building aOcupertino.ora
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PERMIT CANNOT BE FINAI,ED A�I��t�l I'�F,fiE�Ul`�TXT3 THIS!�F�i�'IF�CAT
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon 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 IN,FORMATION
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 Sectio n 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:
ARIBA SMOKE AIGA\R 1 CO ALARM
Outside of.each separate sleeping area in the immediate vicinity of the X ; X
bedroom(s)
On every level of a dwelling unit including basements )( ' 7
Withineachsleeping room X
Carbon Monoxide alarms are not required in dwellings which der not contain fuel-burning appliances and that
der 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,dweRihigunits alarms are permitted to be solely battery operated where repairs or alterations do,
not rresult in the removal of wall and ceilin finishes or there is,nor access by means of attic,basement or crawl
space'..Refer to CRC Section 8314 and CBC S'ectio'ns'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 properly,I hereby certify tTzat Ilio alarms) referenced above has/havebeen,
iristaff,ed in,accordamice wit the manufacturer's instriuction6,ann in, c;:_.G p�l ,,c. ;
d omphan e wvi<h the Califarna Buxldrn�g.
ands C'ai ifonda Residential,'Coles.The alarms have leen tested nod are operational, as of the date sig)ftxed1
belb.w..
(J h,ave)read,and a roe to}cam :I,with, rms;ands condition of thin statema,
Cor�tra`�WNam`e.: � ba
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_. . _ Sagr�atr�ret,.. .. y.._ Dat
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Smoke nn&CO fornv.db.crevised 0311x811:4)
ATTR-CONSERVING PLUM13ING FLUKES
OWNED-CERTIFICATE OFCOMPUANCE
C01ulMUNf Y D£ELOPW,dT:D-EpART4 E-NT*:B11(LD,IN s DIVIS
ILE
Cl PERTINO 10300 TORREAVENUE-CUPERTINO,CA 950143.255
(408)777-3228•FA"X{408) ®buiidinc, 4�perfino.org
Owner Name Y 7 CCAPermit No
Address
h i7 1:C��_ _y -
QX i O
1. Is your real property a registered historical site?
ElYes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form acid sign bottom of form.,
No Go to Question 2,
2. Does your real property have a licenseder lumbcertifying p fyuig that,due to the age or configuration of the property or its
plumbing,installation of water-conserving plumbing fixtures is not technically feasible?
El 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 form and sign bottom of form.
Of 9 No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through.1101.8.do not apply. Skip the rest of the form and sign bottom of form.
f No Go to Question 4.
4. Is your real property built and available for use or occuparcy oft.or before January 1, 1994?
❑ 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 1,199-4.
Civil Code Sections 110.1.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Please check ONE of the following:
MyproP etyis a single ydmilYeidential real roper'y. See Civil Code Section 1101.4. ,
On and after January 1, 2014,building alterations or improvements shall require all non1compliant plumbing,fixtures
to be replaced with water-conserving plumbing fixtures throughout the buildimg.On or before January 1,2017,all non-
compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether
property undergoes alterationsor improvements)..
My property is a:mtcltifamdy,residentialreal property. See Civil Code Section.11011;
0n 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 compliantplumbing fixtures shall be replaced with water-
conserving plumbing fixtures thromghout the bu lding(regardless of whetherpropertymrdergoes alterations or
improvements).
❑ My property is a commercial real property: See Civil Code Section 1101.5.
On and atter January 1,2014,,specified building alterations or improvements shall require ndu-compliant
plumbing fixtures.tot be replaced with water-conserving plumbing fixtures.
OR, or, before. January 1„ 20119,; all non-compliant plumbing fixhires shall be replaced with water- conserving
pl'uiubrng fktwes throughout the building,(regardless of whether property undergoes alteration or improi vement4
1,as.the owner or owner's,agent of this property,certify,under penalty of penury that non compliant plumbing fixtures will be
replaced prior to date,specified above with water.=conserving plumbing fixtures in accordance witht Civit Code Sections 110.=1.1
through 1101.8,the current California Plumbing Code and.California GreenBuildng Standards Code,and manufacturer's
installation.requirements,andd that the.water:-consery ng plumbing,fixtures comply with the requirements as indicated in the
table'. the following,page.
Y r7
. OwnerorOwnerAgerrts Si:griature.�,�:A.
Upon;co m.- and sigm:ing this.Gmti;ficate,please return:it to the Building Division in order to.final your building,permift. '
SB407 201 S doc revised O812.`6/15
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