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15030154CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20891 MCCLELLAN RD CONTRACTOR: SWAN POOLS PERMIT NO: 15030154 OWNER'S NAME: SHAYNE STUBBS 5988 SILVER CREEK VALLEY RD STE 65 DATE ISSUED: 04/08/2015 OWNER'S PHONE: 4082412337 SAN JOSE, CA 95138 PHONE NO: (408) 224 -7926 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑ CONSTRUCT 810 SQ FT INGROUND POOL & 48 SQ FT SPA _ icense Class CS-� Lie. # � 7 .J�.j S� Contractor P'`' S Date 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: 1 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 Sq. Ft Floor Area: Valuation: $75000 rformance of the work for which this permit is issued. lave and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this APN Number: 35913083.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. l agree to comply with all city and county ordinances and state laws relating WITHIN 1 SIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save S FRO I A T C LED INSPEC ION. 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 regul Omns per the Cupertino Municipal Code, Section 9.18. RE- ROOFS: Signa a Date � /�S All roofs shall be inspected prior to any roofing material being installed. if a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. ❑ OWNER- BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 255 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this `Date: permit is issued. Owner or authorized a 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must 1 hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 1 certify that 1 have read this application and state that the above information is correct. 1 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18, Signature Date FEW CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt_ otn )_ Thoco foot aro haled nn tho nroliminary infnrmatinn availahle and are nniv an in imato_ 1"nntart tho Dont fnr addn'l inin_ FEE ITEMS (Fee Resolution 11 -053 E . 7/1/13) ADDRESS: 20891 mcclellan rd DATE: 03/25/2015 REVIEWED BY: Mendez APN: BP #: D 'VALUATION: 1$75,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Suppl. PC Fee: (j) Reg. OT PENTAMATION RBSP PERMIT TYPE: WORK construct 810 sq ft in round pool & 48 sq ft spa SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt_ otn )_ Thoco foot aro haled nn tho nroliminary infnrmatinn availahle and are nniv an in imato_ 1"nntart tho Dont fnr addn'l inin_ FEE ITEMS (Fee Resolution 11 -053 E . 7/1/13) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 Fi&fl s.f. $1,789.00 Swimming Pool IPOOLGUNIT Gunite Suppl. PC Fee: (j) Reg. OT 1 0.0 1 hrs $0.00 PME Plan Check: $0.00 = # $0.00 Swimming Pool 1 Spa or Hot Tub (Pre -Fab) Permit Fee: $0.00 Suppl. Insp. Fee:0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? 0 Yes (j) No $0.00 Advanced Plannin& Fee: $0.00 Select a Non - Residential Building or Structure G Q Strong Motion Fee: IBSEISMICR $9.75 Select an Administrative Item Bld * S ,t�ommission Fee: IBCBSC $3.00 SUBTOTALS: $12.751$1,789.001 TOTAL FEE: 1 $1,801.751 Revised: 02/14/2015 CUPERTINO SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 � S P (408) 777 -3228 - FAX (408) 777 -3333 - building(cDcupertino.org 'J PROJECT ADDRESS 2-0 bc' I CC.I_ (Cx. (Z� APN # OWNER NAME St \&=Inc .S bhs Csj,i-ft PHONE `w,,_� - Z y /- L3s E -MAIL STREET ADDRESS zc:)�9 (Lo CITY, STATE, ZIP C.(+ `�Sb FAX t 0- uzQ ti C.� CONTACT NAME PHONE fG - ZZy - �` Z E -MAIL Se ti I.✓��_�d S� „ct or,ls �jez C{i1e?a -c STREET ADDRESS fs e, CITY, STATE, ZIP !', , ' r+ 9573 ,? FAX -Z Zs - 792[<-, ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME p LICENSE NUMBER -4q LICENSE TYPE BUS. LIC # Cam,,, rt f 5 COMPANY NAME E -MAIL C _C, FAX yv�-zzS = :iV52_ Q. STREET ADDRESS , C�ieelc 01” CA CITYxSTATE, ZIP ar_ 9f -3 PHONE G Z I/- % Z / Z urn p ,& r�r, ]� ARCHITECTIENGINEER NAME LICENSE NUMBER I BUS. LIC # COMPANY NAME E -MAIL FAX -t -� �75 Y STREET ADDRESS CITY, STATE, ZIP PHONE 120 ( /t.. ✓s, ,.) A, DESCRIPTION OF WORK rie4,, " USE OF Nr- SFD or Duplex ❑ Multi - Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION (S) STRUCTURE: ❑ Commercial POOL �-1 '61 O POOL/SPA MATERIAL TYPE CODES: SPA l� V - VINYL -LINED DEMO F - FIBERGLASS G - GUNITE RECEIVED BY: TOTAL VALUATION: P - PREFABRICATED S co By my signature below, I certify to each of the following: I am the property owner or authWfzed agent to a`c>Vn the property owner's behalf. I have read this application and the information I have provided is co ect. I have read the Description of Work an ven I Is accurate. I agree to comply with aII applicable IocaI ordinances and state laws relating to buildin ion. I authorize representatives of Cuper ino to enter the above - identified property for inspection purposes. Signature of ApplicantlAg - _ Date: 3/Z SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP Commercial or Multi- Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. ❑ OVER - THE - COUNTER ❑ BUILDING DEPT ❑ EXPRESS ❑ PLANNING DEPT ❑ STANDARD ❑ PUBLIC WORKS DEPT ❑ LARGE ❑ ENVIRONMENTAL HEALTH ❑ MAJOR ❑ SANITARY SEWER DISTRICT SwimPoolApp_201 Ldoe revised 03116111 Owner Name WATER- CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE FILE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION _ f f 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 J (408) 777 -3228 • FAX (408) 777 -3333 buildinaacuDertino.org ' Permit No. Address_/ PERMIT CANNOT BE FINALED AND CO- MPLETED UNTIL THIS CERTIFICATF, HAS BEEN STGNFD 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? ., ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.' Sign below and skip the rest of the form Owner' Signature: Date: [p' Noy Go to Question 2. 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? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form Owner' Signature: Date: KNo Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: No Go to Question 4. Date: 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. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form Owner' Signature: Date: 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. Refer to the attached. I, 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 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 plumbing fixtures. SB407 2014.doc revised 03118114 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/We, the owner(s) of this property, certify under penalty of perjury that non - compliant plumbing fixtures have been replaced with water - conserving plumbing fixtures in accordanc with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Gre=n Bull ing Stand Vs Code, and manufacturer's installation requirements, and that the water - conserving plumbing fixture ,o vIv itY the recafirements as indicated in the table below. Owner's (or Owner Agent's) Signature: &Z / 1,44 Date: 147;t / // ,�— Upon completing and signing this Certificate, �fease r1tum 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 required to be upgraded. SB4072014.doc revised 03118114 Non- Compliant Water- Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 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 gallons /flush 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 required to be upgraded. SB4072014.doc revised 03118114 J CALIFORNIA CIVIL CODE SECTIONS 1101.1- 1101.8 Civil Code Division 2. Property Part 4. Acquisition of Property Title 4. Transfer Chapter 2. Transfer of Real Property Article 1.4. Installation of Water Use Efficiency Improvements ........ 1101.1 -- 1101.8 1101.1. The Legislature finds and declares all of the following: (a) Adequate water supply reliability for all uses is essential to the future economic and environmental health, of California. (b). Environmentally _sound, §trategies to meet future water supply and wastewater treatment needs are key to protecting and restoring - aquatic resources in Ealifomia. �...(crThere is apressinggneed to address-.watee supply reliability issues raised by growing urban areas. - (d)- Economic analysis by urbanlwateT agencies ha§-identified urban "water conservation as a cost- effective - approach to addressing. water :supply.needs. (e)-There are many water conservation practices that produce significant energy and other resource savings that should be encouraged as a matter of state policy. (f) Since the 1991 signing of the "Memorandum of Understanding Regarding Urban Water Conservation in California," many urban water and wastewater treatment agencies have gained valuable experience that can be applied to produce significant. statewide savings of water, energy, and.associated infrastructure costs. This experience indicates a need to regularly revise and update water conservation methodologies and practices. (g) To address these concerns, it is the intent of the Legislature to require that residential and commercial real property built and available for use or occupancy on or before January 1, 1994, be equipped with water - conserving plumbing fixtures. (h) It is further the intent of the Legislature that retail water suppliers are encouraged to provide incentives, financing mechanisms, and funding to assist property owners with these retrofit obligations. 1101.2. Except as provided in Section 1101.7, this article shall apply to residential and commercial real property built and available for use on or before January 1, 1994. 1101.3. For the purposes of this article: (a) "Commercial real property" means any real property that is improved with, or consisting of, a building that is intended for commercial use, including hotels and motels, that is not a single - family residential real property or a multifamily residential real property. (b) "Multifamily residential real property" means any real property that is improved with, or consisting of, a building containing more than one unit that is intended for human habitation, or any mixed residential- commercial buildings or portions thereof that are intended for human habitation. Multifamily residential real property includes residential hotels but does not include hotels and motels that are not residential hotels. (c) "Noncompliant plumbing fixture" means any of the following: (1) Any toilet manufactured to use more than 1.6 gallons of water per flush. (2) Any urinal manufactured to use more than one gallon of water per flush. (3) Any showerhead manufactured to have a flow capacity of more than 2.5 gallons of water per minute. (4) Any interior faucet that emits more than 2.2 gallons of water per minute. (d) "Single - family residential real property" means any real property that is improved with, or consisting of, a building containing not more than one unit that is intended for human habitation. (e) "Water- conserving plumbing fixture" means any fixture that is in compliance with current building standards applicable to a newly constructed real property of the same type. (f) "Sale or transfer" means the sale or transfer of an entire real property estate or the fee interesfin'diat real property estate and does not include the sale or transfer of a partial interest, including a leasehold. 1101.4. (a) On and after January 1, 2014, for all building alterations or improvements to single - family residential real property, as a condition for issuance of a certificate of final completion and occupancy or final permit approval . by the local building department, the pen-nit applicant shall replace all noncompliant plumbing fixtures with water - conserving plumbing fixtures. M (b) On or before January 1, 2017, noncompliant plumbing fixtures in any single - family residential real property shall be replaced by the property owner with water - conserving plumbing fixtures. (c) On and after January 1, 2017, a seller or transferor of single - family residential real property shall disclose in writing to the prospective purchaser or transferee the requirements of subdivision (b) and whether the real property includes any noncompliant plumbing fixtures. ` 1101.5. (a) On or before January 1, 2019, all noncompliant plumbing fixtures in any multifamily.residential real property and-in any commercial real property shall be replaced with water - conserving plumbing fixtures, (b) An owner or the owner's agent may enter the owner's property for the purpose of installing, repairing, testing, and maintaining water - conserving plumbing fixtures required by this section, consistent with notice requirements of Section 1954. (c) On and after January i; 2019; the water - conserving plumbing fixtures requited by this section sh ill .be operating at the manufacturer's rated water consumption at the time that the tenant takes possession. A,tenant shall betegponsible for'notifying'the owner or owner's agent if the tenant becomes aware that a water-- conserving lumbin -- fixture within his or her unit is not o eratin at the manufacturer's rated water consum tio�i The -owner p.._ .. g p g. p or owner's agent shall correct an inoperability in a water - conserving plumbing fixture upon notice byte teriant or if detected by the owner or the owner's agent. (d) (1) On and after January 1, 2014, all noncompliant plumbing fixtures in any multifamily residential real property and any commercial real property shall be replaced with water - conserving plumbing fixtures in the following circumstances: (A) For building additions in which the sum of concurrent building permits by the same permit applicant would increase the floor area of the space in a building by more than 10 percent, the building permit applicant shall replace all noncompliant plumbing fixtures in the building. (B) For building alterations or improvements in which the total construction cost estimated in the building permit is greater than one hundred fifty thousand dollars ($150,000), the building permit applicant shall replace all noncompliant.plumbing fixtures that service the specific area of the improvement. (C) Notwithstanding subparagraph (A) or (B), for any alterations or improvements to a room in a building that require a building permit and that room contains any noncompliant plumbing fixtures, the building permit applicant shall replace all noncompliant plumbing fixtures in that room. (2) Replacement of all noncompliant plumbing fixtures with water - conserving plumbing fixtures, as described in paragraph (1), shall be a condition for issuance of a certificate of final completion and occupancy or final permit approval by the local building department. (e) On and after January 1, 2019, a seller or transferor of multifamily residential real property or of commercial real property shall disclose to the prospective purchaser or transferee, in writing, the requirements of subdivision (a) and whether the property includes any noncompliant plumbing fixtures. This disclosure may be included in other transactional documents. 1101.6. The duty of an owner or building permit applicant to comply with the requirements of this article shall be postponed for one year from the date of issuance of a demolition permit for the building. If the building is demolished within the one -year postponement, the requirements of this article shall not apply. If the building is not demolished after the expiration of one year, the provisions of this article shall apply, subject to appeal to the local building department, even though the demolition permit is still in effect or a new demolition permit has been issued. 1101.7. This article shall not apply to any of the following: (a) Registered historical sites. (b) Real property for which a licensed plumber certifies that, due to the age or configuration of the property or its plumbing, installation of water - conserving plumbing fixtures is not technically feasible. (c) A building for which water service is permanently disconnected. 1101.8. A city, county, or city and county, or a retail water supplier may do either of the following: (a) Enact local ordinances or establish policies that promote compliance with this article. (b) Enact local ordinances or establish policies that will result in a greater amount of water savings than those provided for in this article. -W CUPERTINO Address 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 • building -cuaertino.org FILE /! - - it a;b- PER ,111T CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN 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 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 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 have been tested and are operational, as of the date signed below. 1 have read and agree to c5ft1v it the ter and conditions of this statement er (or Owner Agent's) Nam zlo-- Si nature....... .. . ...... ............................... ............................... Date:l..t�l.•.:•• Contractor Name: Si nature.. Lic.# l.�F.1...�!5�........... Date: Smoke and CO form.doc revised 03118114