Loading...
B-2016-1238CITY OF .CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-1238 10592 CULBERTSON DR CUPERTINO, CA 95014-3556 (375 34 034) HOMEOWNER BUILDER OWNER'S IE: BISWASAMITAVATRUSTEE&ETAL DATE ISSUED: 04/07/2016 OWNER'S PHONE: 408-663-7232 PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic. # Contractor HOMEOWNER BUILDER Date X BLDG —ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH X RESIDENTIAL — COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT (N) ATTACHED 2ND UNIT WITH 382 S.F. I hereby affirm under penalty of perjury one of the following two. declarations, 1. 1 have and will maintain a certificate of consent to self -insure for Worker's REV # 1 - CLARIFY/REVISE INTERIOR SHEAR_ WALL - ISSUED Compensation, as provided for by Section 3700 of the Labor Code, for the 8/1/16 performance of the work for which this permit is issued. , 2. I have and will maintain Worker's Compensation Insurance, as provided for by REV # 2 - CHANGE TYPE OF WATER HEATER FROM TANKLESS TO Section 3700 of the Labor Code, for the performance of the work for which this 50 GALLON; CHANGE INSULATION TO TYPE R-28 IN CEILING; permit is issued. CHANGE TITLE 24 ENERGY DESIGNER - ISSUED 8/11/2016 Sq. Ft Floor Area: 382 Valuation: $36000.00 APPLICANT CERTIFICATION 1 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 APN Number: Occupancy Type: representatives of this city to enter upon the above mentioned property for 375 34 034 Deferred Submittal (R -3),R-3 (Custom) 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. this permit. Additionally, the applicant understands and willl comply with all ll non -point PERMIT EXPIRES IF WORK IS NOT STARTED source regulations per the Cupertino Municipal Code, Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Y 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 8/15/2016 Issued by; Abby Ayende OWNER -BUILDER DECLARATION Date: 04/07/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: RE -ROOFS: r. I, as owner of the property, or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installed. If a roof is compensation, will do the work; and the structure is not intended or offered for installed without first obtaining an inspection, I agree to remove all new materials for —sale (Sec.7044, Business & Professions Code) as owner of the property, am exclusively contracting with licensed inspection. /2��l Gr contractors to construct the project (Sec.7044, Business & Professions Code). Signature ofApplicant: I hereby affirm under penalty of perjury one of the following three declarations; Date: 8/15/2016 I have and will maintain a Certificate of Consent to self -insure for Worker's r Compensation, as provided for by Section 3700 of the Labor Code, for the ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER performance of the work for which this permit is issued. 2. I have and will maintain. Worker's Compensation Insurance, as provided for by i HAZARDOUS MATERIALS DISCLOSURE Section 3700 of the Labor Code, for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the permit is issued. California health & Safety Code, Sections 25505, 25533, and 25534. I will 3. 1 certify.that in the performance of the work for which this permit is issued, I maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the shall not employ any person in any manner so as to become subject to the Health & Safety Code, Section 25532(a) should I store or handle hazardous Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I Labor Code, I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and be deemed revoked. the Health & Safety Code, Sections 25505, 25533, and 25534. //rte APPLICANT CERTIFICATION OHr" 'ner or authorized agent: certify that I have read this application and state that the above information is li Date: 8/15/2016 correct. I agree to comply with all city and county ordinances and state laws CONSTRUCTION LENDING AGENCY relating to building construction, and hereby authorize representatives of this city I hereby affirm that there is a construction lending agency for the performance to enter upon the above mentioned property for inspection purposes. (We) agree of work's for which this permit is issued (Sec. 3097, Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit., Additionally, the applicant understands Lender's Address and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION /jI - 8/15/2016 understand my plans shall be used as public records. Sig ugnatre Pi't/�''� ate Licensed CONSTRUCTION PERMIT APPLICATION' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION kv 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)777- 3228 FAX (408) 777-3333 • buildingCcDcupertino.org wig • (J NEW CONSTRUCTION U ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS t C/ J p ( � ® V� ^ APN # OWNER NAME TSA ITA, jJ ' 1 1 S °JAS PHONE L}-0 5 Lb 3 -L3 � 3 E -MA L a LYIMJ STREET ADDRESS// �' (��! �rCJ V C��,4 b 9 p CITY, STATE, ZIP a A � 0 (f 5-01 FAX CONTACT NAME !.t- In A '� � Pl �{� PHONE F/ Ci p 3 �'"3 `�� E-MAIL GL Y�{i! Li.� � L� a. e>✓J (�C �? STREET ADDRESS1 V l 1JC4j 0 .3?61 CITY, STATE, ZIP (� qLG 1 9 �9 J ( FAX E ❑ mvNER uVown'ER-HuiLDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ' CONTRACTOR NAMEya� �1�� LICENSE NUMBER LICEATSE TYPE BUS. LIC # I COMPANY NAME I E-MAIL I FAX I STREET ADDRESS I CITY, STATE, ZIP I PHONE ARCHITECT/ENGINEER NAME I LICENSE NUMBER I BUS. LIC # COMPANY NAME I EMAIL I FAX I STREET ADDRESS I CITY, STATE, ZIP ' I PHONE DESCRIPTION OF WORK IS A SECOND UNIT ❑ YES SECOND STORY []YES V-ateA 2 G c -,mss IJ- i 01+ i,ll, g BEBVGADDED? NO EXISTING USE. PROPOSED USE CONSTR. TYPE 4 STORIES PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF > , ` J USE TYPE OCC, SQ.FT. VALUATION ($) EXISTG _ NEW FLOOR DEMO TOTAL By my signature below, I certify to each of the following: I am the property owner or authorized agent to a4 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 \York and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. eZ AREA SUPPLEMENTAL INFORMATION REQUIRED Q AREA AREA NET AREA. ❑ ovER rirE couNR ❑ $uILDIi\G PLAi�rREViEw existing building(s). Demolition permit is required prior to issuance of building BATHROOM ,fl EarREss KITCHEN OTHER nN 0� 2R O Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTAhDaRD v rUBLIc•oRxs REMODEL AREA REMODEL AREA REMODEL AREA LARGE'`' ❑ RHtE DEPT; Copy of Plarming Approval Letter or Meeting with Planning prior to ❑ I•��JOR ❑ SA7ITTAHYSEP��ERDISTRICT � PORCH AREA I DECK AREA I TOTAL DECK/PORCH AREA I GARAGE AREA: Fl DETACH ATTACH DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEBVGADDED? NO ADDITION? NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS. THE BLDG AN ❑ YES kREC ED $T' TOTAL VALUATION: PLANNLNGAPPLi# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? NO a _ By my signature below, I certify to each of the following: I am the property owner or authorized agent to a4 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 \York and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. eZ Signature of Applicant/Agent: Date: _ / 12�1 SUPPLEMENTAL INFORMATION REQUIRED Q _ �° ° ,; v PLAIVCHECKTIPE .. :� �F ROIJTINGStIP-, _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ ovER rirE couNR ❑ $uILDIi\G PLAi�rREViEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. ,fl EarREss ❑Pi�nH,GrLArxEyIEw nN 0� 2R O Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTAhDaRD v rUBLIc•oRxs fomi if any Hazardous Materials are being used as part of this project. -_ LARGE'`' ❑ RHtE DEPT; Copy of Plarming Approval Letter or Meeting with Planning prior to ❑ I•��JOR ❑ SA7ITTAHYSEP��ERDISTRICT � submittal of Building Permit application. ,- BldgApp_2011.doc revised 06121111 I WE 0 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10592 CULBERTSON DR CUPERTINO, CA 95014-3556 (375 34 034) CONTRACTOR: OWNER/BUILDER PERMIT NO: B-2016-1239 OWNER'S NAME; BISWAS AMITAVA TRUSTEE & ET AL DATE ISSUED: 04/07/2016 OWNER'S PHONE: 408-663-7323 PHONE NO: LICENSED CONTRACTOR'S DF T ARA11ON BUILDING PERNUT INFO: License Class Lic. # Contractor OWNER/BUILDER Date X BLDG —ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT (N) ATTACHED 2ND UNIT WITH 382 S.F. I hereby affirm under penalty of perjury one of the following two declarations: i. I have and will maintain a certificate of consent to self -insure for Worker's REV # 1 - CLARIFY/REVISE INTERIOR SHEAR WALL - ISSUED Compensation, as provided for by Section 3700 of the Labor Code, for the 8/1/16 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. Sq. Ft Floor Area: 382 Valuation: $36000.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 375 34 034 Deferred Submittal (R -3),R-3 (Custom) 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. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS F ST CALLED INSPECTION. Signature Date 08/01/2016 Issued by: Date: OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: followug1 two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is { f` 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) 1, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044, Business &Professions Code). Date: 08/01/2016 �I hereby affirm under penalty of perjury one of the following three declarations: - ` _I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER - Compensation, as provided for by Section 3700 of the Labor Code, for the I performance of the work for which this permit is issued. I HAZARDOUS MATERIALS DISCLOSURE i, have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 the Labor Code, for I have read the hazardous materials requirements under Chapter 6.95 of the California Health &Safety Code, Sections 25505, 25533, 25534. I of the performance of the work for which this and 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 Worker's Compensation laws of California. If, after making this certificate of 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 exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be c deemed revoked. Owner or authorized agent. d -z APPLICANT CERTIFICATION Date: 08/01/2016 1 certify that I have read this application and state that the above information is CONSTRUCTION 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 expenses 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. 1 understand my plans shall be used as public records. ,, � ,ter' Signature ' f /�" " ""� - V Date 08/01/2016 - Licensed Professional CONSTRUCTION PERMIT APPLICATION' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300. TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingQ-cupertino.org LJ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/ TI REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS Ito 5- 9) 1 S o Q APN # 3�-03 03 /F OWNERNAME d,/� ( $� y��7 �{...'��.� k f � i I T 'V T/ ii � �-. PHONE E-MAIL � STREET ADDRESS i ®ry -S p `CITY, STATE, ZIP C _A - " �j �r FAX CONTACT NAME A-sA„ i l A - IT 1 �1% �- PHONE �✓ LJ� � E-MAIL 6 YV� �.fzv t C W & A� STREET ADDRESS d ��`' o W � o %" CITY, STATE, ZIP �' i, FAX ❑ OWNER E 'O 1WNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENS CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK �f ew ordinances and state laws relating to building construction. I authorize representatives of Cupertino EXISTING USE �S t ROPOSED US�E�����y V (JIx'r-r �� CONSTR. TYPE - V # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) AREAEXISTL 779 AREA NEW FLOOR 392-1 DEMO TOTAL AREA — NET AREA 1 e existing building(s). Demolition permit is required prior to issuance of building J BATHROOM REMODEL AREA ._– KITCHEN - REMODEL AREA e— OTHER REMODEL AREA © `PI;ANNING;P,LAN REVIEW r .. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure?siAND�Tin PORCH AREA ^-- DECK AREA TOTAL DECK/PORCH AREA — I GARAGE AREA: EIDETACH ❑ ATTACH. == #DWELLING UNITS: ISA SECOND UNIT LVrYES SECONDSTORY ❑YES BEING ADDED? E]NO ADDITION? 2 -NO IS THE BLDG AN ❑ TOTAL VALUATION: PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? Q�N 0 h By my signature below, I certify to each of the following: I am the property owner or authorized agent t on erty owner's behalf. ve read this application and the information I have provided is correct. I have read the Description of Work and veri I Is accurate. I agree to coruply with all licable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspectio purposes. Signature of Applicant/Agent: � Date: t 2 �i 116 SUPPLEMENTAL INFORMATION REQUIRED Q t rLANe$EcxTW>;�, INQPi v,Rl IEE, _ New SFD or Multifamily dwellings: Apply for demolition permit for❑ existing building(s). Demolition permit is required prior to issuance of building J permit for new building. � l EXPRESS" © `PI;ANNING;P,LAN REVIEW r .. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure?siAND�Tin ❑ PUBLIC woxxs form if any Hazardous Materials are being used as part of this Project., .- == LARGE .©. FIRE DEPT . , Copy of Planning Approval Letter or Meeting with Planning -prior to submittal of Building Permit application; ArAJOR ._ rTAIzX sEyvl RDIs q ; BIdgApp_2011.doc revised 06121111 May 17, 201 C B15WA5 E5IDENCE 10592: C LBERT50N DRIVE CUPERTIN , CA 95014 dub e Review of the 1loldown 1501t5 Dear Mr. B15wa5 : At.your rectue5t, we have reviewed total 4 holdown bolts retrofit for the project mentioned above on 5/1 6/201 G. To the best of our knowledge and. based on our ob5ervation5 through the accessible areas, the work of the retrofit holdown bolts in the existing concrete footing, used HTT5 and 5/8" diameter all -thread rod with double nuts and 3" Sctuare washer, were in general conformance with the city approved plan dated on 3/27/201 G. This review is conceptual and ctualitative. It is Intended to verify the presence of mayor Structural connections and to identify mayor deficiencies. The above information constitutes the professional opinions of AQX EngineermcJ, Inc. in accordance with generally accepted engineering principles and pre5ented above are based on a limited reconnaissance. No physical testing examine areas not readily accessible. We do not undertake the guarantee of the construction, nor do we relieve the contractor from his re5pon5lblilty to produce a completed project conforming to the plans. should you have any ctue5t1on5 regarding this matter, please feel free to call. AQX Enciincerinqj, INC. o QROFESS/pN9: S. 5289 6525 CROWN BLVD. #41068 * EV. 6/30/16 SAN JOSE, CA. 95 1 GQ `RuN��' TEL: 408-229-35 17 TF of cAUF°` www.ac[xencj.com - 5/17/201 G CUPERTINO Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 40&-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: 10. 5-9 2 CAJ bzArlso%A At . PERMIT # /2-3g OWNER'S NAME: A N t h VA Z? � . w PHONE # GENERAL CONTRACTOR: h M TAj /} f}S' BUSINESS LICENSE # ADDRESS: Joy -9O tcaheA�X6W-,o. CITY/zIPCODE: fir.. IeA xuur municipal code requires all businesses working in'.the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL. OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not _using any subcontractors: Signature Date_ Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing V Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing V Roofing i �ti _7 Z 6 S— Septic Tank Sheet Metal Sheet Rock Tile 2-0 16 Owner / Contractor Signature Date CVPERTINO ._iCddress= PURPOSE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(d)cupertino.org /-- l b � Ear_ OY ier]wt�o' 16 12 3 8 �� ✓ Z- ", ✓ti -3�7-cgr cif m—oa PERMIT CAANNT BB MNALED AND Ci mpLETED UNTIL TMS_ CERTIFICATE HAS BEEN AND RETi?i?NFH TO THE 1E3LiILDI1ITG DIVISION 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 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 $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section. 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comn1v with the terms and conditions of this statement VA- 515w.*$ C®w v-� b" / :..../Q.." .�...."..........................................................................................:: !f� Ltc.1# . Date:: .... Smoke and CO forntdoc revised 03/18/14 CUPERT'INO { caner ame A ess WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 777-3228 • FAX (408) 777-3333 • buildina0—cupertino.org 0 W 2,0/6-1235 IM Ct� 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 form. 19"IVo Go to Question 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. Skip the rest of the form and sign bottom of form. P<O 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. Lii<o Go to Question 4. 4:) Is your real property built and available for use or occupancy on or before January 1, 1994? S" I'To 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.. {S_.) Please check ONE of the following: ❑ 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. 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 -Daae. --'P.0 0516.1 l C131/2 -m/6 Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB40 7 2 015. doe revised 08/26/15 BUILDING PERMIT CANI�?flT BE FINAL] AND CORIPLETED Ul\�TIL THIS CERTIFICATE HAS BEEN -I Ii R t LTRI ED T4 THE BUDN G DIYI�Ifl1�T 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. SB4072015.doc revised 08/26/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Wafer 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 Gallons/flush 0.5 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. SB4072015.doc revised 08/26/15