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B-2017-1212 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1212 10253 PARKWOOD DR APT 8 CUPERTINO,CA(326 27 037) THERMAL MECHANICAL SANTA CLARA,CA 95054 OWNER'S NAME: AVERY GLENBROOK LP DATE ISSUED:08/08/2017 • OWNER'S PHONE:650-961-8330 PHONE NO:(408)988-8744 ... S► t: t'_ _ . BUILDING PERMIT INFO: License Class C-[4:10:20:36:38 Lic.#256057 Contractor THERMAL MECHANICAL Date 01/31/2018 x BLDG X ELECT X PLUMB X 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: BLDG#43/UNIT#8;ADD(N)A/C;REPLACE FURNACE,SAME I hereby affirm under penalty of perjury one of the following two declarations: LOCATION;(N)WASHER AND DRYER HOOK UPS;(N)ELECTRICAL 1. I have and will maintain a certificate of consent to self-insure for Worker's SERVICE(70 AMP);(N)GAS LINE FOR STOVE;(N)RECEPTACLE Cs Baa pensation,as provided for by Section 3700 of the Labor Code,for the OUTLETS;(N)LIGHT;(N)BATHROOM EXHAUST FANS. erformance of the work for which this permit is issued. REV#1-CHANGE LOCATION OF FURNACE TO ATTIC SPACE- I have and will maintain Worker's Compensation Insurance,as provided for by ISSUED 10/13/2017 Section 3700 of the Labor Code,for the performance of the work for which this • permit is issued. Sq.Ft Floor Area: Valuation:$20000.00 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 statellaws,relating to building construction,and hereby authorize 326 27 037 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 regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. �T. lona ur Date 10/13/2017 Issued by:ABBY AYENDB Date:08/08/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am 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:10/13/2017 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 become subject to the Worker's Compensation provisions of the the Health&Safety Co ,Sections 25505,25533 Labor Code,I must forthwith comply with such provisions or this permit shall /0°°'oppo be deemed revoked. "'" Aar � er or authorized age, . -air! APPLICANT CERTIFICATION ate:10/13/2017 I 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 ad 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 theabove 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. I understand my plans shall be used as public records. Licensed Signature Date 10/13/2017 Professional CONSTRUCTION PERMIT APPLICATION . -eAl lit). \e,,, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 4"-c.15,,, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinq(a).cupertino.orq ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI IN REVISION/DEFERRED ORIGINAL PERMIT iig- I f i ,y=t PROJECT ADDRESS 10253 Parkwood DR, BLDG 43, Unit#3 APN# OWNER NAME PHONE E-MAIL AveryGlenbrook LLC 650-961-8330 averY@pacbell.net STREET ADDRESS 130 East Dana Street CITY,STATE,ZIP Mt.View, CA 94041 FAX 650-961-0571 CONTACT NAME Rob Moyer PHONE 408-593-8115 E-MAIL rmoyer@thermalmech,com STREET ADDRESS 425 Aldo ave. CITY,STATE,ZIP FAX 408-988-0233 Santa Clara, CA 95054 ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT IX CONTRACTOR 0 CONTRACTOR AGENT. 0 ARCHITECT ❑ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME LICENSE NUMBER 256057 LICENSE TYPE BUS.LIC# 299 Thermal Mechanical C-4,10,20,36,38 COMPANY NAME Thermal Mechanical E-MAIL rmoyer@thermalmech.com FAX 408-988-0233 STREET ADDRESS 425 Aldo ave. CITY,STATE,ZIP Santa Clara, CA 95054 PHONE 408-988-8744 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK - 9t viid—.,'. : Change location of Furnace to attic space EXISTING USE PROPOSED USE ' CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETACH 0 ATTACH #DWELLING UNITS: ISA SECOND UNIT ❑YES SECOND STORY OYES BEING ADDED? ONO ADDITION? 0N PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES CEIVED BYE„ t a TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO � �°'� w.., fir/ � By my signature below,I certify to each of the following: I am the property owner or au ed agent to act on the property owner's beha f. I have read this application and the information I have provided is correct. I e read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons.. ..;---e represen./es of Cupertino to enter the above-identifi roperty r inspection purposes. Signature of Applicant/Agent: ` — Date: � �/� SUPPLEMENTAL INF%• ATION REQUIRE • PLAN CHECK TYPE , ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ,f k� existing building(s). Demolition permit is required prior to issuance of building r-0 ovER T eoUNT>vR,�< ° 1-❑ Btntr.-mei L0,40,,r w � ��y permit for new building. ❑-.EXPRESSO ❑PIANNINGPLAN.REVIEW _Commercial Bld s: Provide a com leted Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ,0❑ LARGE 4;: "�K- 4FIRE�DEI'T 14 Copy of Planning Approval Letter or Meeting with Planning prior to s 't.'`; ❑ MAJOR r z ❑ SANITARY SEWER DISTRICT ' submittal of Building Permit application. 1 ~ S wr., �, 3/r,;E,NYIRON ENNTAUHEALTI ,,;'e.x)%; BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1212 10253 PARKWOOD DR APT 8 CUPERTINO, CA (326 27 037) THERMAL MECHANICAL SANTA CLARA, CA 95054 OWNER'S NAME: AVERY GLENBROOK LP ISSUED: 08/08/2017 OWNER'S PHONE: 650-961-8330 1 1 PHONE NO: (408) 988-8744 License Class C36 Lic. #258057 Contractor THERMAL MECHANICAL Date 01/31/2018 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: m. 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. ve 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. 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 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, 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 regulations per ft -Cupertino Municipal Code, Section 9.18. Signatt ..�® Date 08/08/2017 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: m. 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: m. 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. 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. 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, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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, 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 regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 08/08/2017 BUILDING PERMIT INFO: X BLDG X ELECT X PLUMB X MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: BLDG #43/UNIT #8; ADD (I) A/C; REPLACE FURNACE, SAME LOCATION; (I) WASHER AND DRYER HOOK UPS; (1) ELECTRICAL SERVICE (70 AMP); (N) GAS LINE FOR STOVE; (I) RECEPTACLE OUTLETS; (N) LIGHT; (I) BATHROOM EXHAUST FANS. Sq. Ft Floor Area: I Valuation: $20000.00 "N Number: Occupancy Type: 326 27 037 PERMIT EXPIRES IF,WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 08/08/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If'a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 08/08/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use'equipment or devices which emit hazardous 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 the Health & Safety Cade, Se tions 25505, 25533 d 25534. Owner or authorized ageR Date: 08/08/2017 ®® CONSTR CTION LENDINGA E I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CUPERTINQ CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION 0 ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10253 Parkwood DR, BLDG 43, Unit #8 APN#® ,�� OWNER NAME: Ave Glenbrook LLC Avery PHONE 650-961-8330 E-MAIL avery@pacbell.net rY@P STREET ADDRESS 130 East Dana Street CITY, STATE, ZIP Mt. View, CA 94041 FAX 650-961-0571 CONTACT NAME Rob Moyer PHONE 408-593-8115 E-MAIL rmoyer@thermalmech.com STREET ADDRESS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 FAX 408-988-0233 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT IX CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER El TENANT CONTRACTORNAME Thermal Mechanical LICENSE NUMBER 256057 LICENSE TYPE BUS. LIC# 299 C-4,10,20,36,38 COMPANYNAME Thermal. Mechanical E-MAIL rmoyer@thermalmech.com FAX 408-988-0233 STREETADDRESS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 PHONE 408-988-8744 l ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK add new AC, replace furnace in same location, (N) washer/dryer hook ups, (N) electrical panel (70 AMP), (N) gas line for stove, (N) electrical outlets, (N) light, (N) bathroom exhaust fan EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC.7SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH I []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? E]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL #. ❑ NO PLANNING APPROVAL LETTER IS TBE BLDG AN []YES EICHLER HOME? []NO �REC j5 $}° �`*T /�/ °//vFroi iza "i",a�/ "` >�"^ �G r �� ��`��",.,S.,G�GG, TOT VALUATION: � , vii✓/u���a - c... By my signature -below, I certify to each of the following: I am the property ownerorauthorized agent -to ac on.the roperty owner's -behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building co c I . I aut orize representatives of Cupertino to enter the above -identified ropertyfor inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL FORMATIONREQUIRED f � � � � � PLAN/GHECKTYPI r, , . ,. 7xar/h ��,, 1WAPP? I Nfy.YlTII+iG,SLIP New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of buildings CTILA���, permit for new building.St �Xe>7�Ss,„� ��rNii�tt ATu v[�w 310 H �,ry�/ih4o,/ LSA' `�`''"✓"z ��°i4,2�,G'. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure©; STANDAT2A`/// n® �usLicwoltlF�� form if any Hazardous Materials are being used as part of this project. / r Tis LARCI'tN1=1 w-.�//�l,✓Fq��f'«x t&/X/�'",z PT m u /s/�/zF///,�/�//�/t �i'd9�t„ �^K74ns Copy of Planning Approval Letter or Meeting with Planning prior to Q 14tAJOR ' /6 / Y SEWEk DTS fXtCC s€ submittal of Building Permit application. pSiIT 6/ "yt B1dgApp_2011.doc revised 06121/11 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO10300 TORRE AVENUE• CUPERTINO CA 95014-3255 (408)777-3228•FAX(408)777-3333.•buildinaCo?cupertino.orq A. -• . .,,.. ...-.>„._Es..-.s-.•.&.... e< oie _l , O _ ALFAMS. �.�,. � d�.'�...�.: �� � ..�shat.§M�>�,,�'�.a � .�n.<,d: ::z•; � .>e ._. „ x , �� �``�,'�'S _.. �� '`;�:••:�;''�. .,y,.., qc:4;-• :.,�'R..$,.s: . w ,._..... ,,. .....,.__ .;�r,,«. �••:.•„re;;«.....:.n•....:xr..:: wcsa>.W«.<„<»:....., :. ��`z«r,,.'�.'';•--:�:_: . z'r'<s;�:: :�'•, ^ .,_ . ..`.;�,"_`,.. �::e."" 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 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 bedroom(s) On every level of a dwelling unit including basements X X1 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-cane is faaarpower 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--�-l re is no access by means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2;114 and 420 6.2.An electrical permit is required for alarms which must be connected to the building iVipnzg. As owner of the above-referenced property,I hereby certify that the alarrn(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. /6 2S3a-4r w6919I " -e Permit No 2a/7- 11/4' Specify Number of Alarms - #Smoke Alarms. #Carbon Monoxide Detectors. Fri I have read and agree to complywith the nd conditions of this statement Owner(or Owner Agent's)Name' • 0 f PC'"- Date a Signature ConIractor Name:: erk- t e ,�a.L I Signature � Lica e� J �' Dalel'3./'/ cmnL-n in1.719/Inn rai cni?110/7711 j / \ / WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE .45�.,nss COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO TORRE AVENUE•CUPERTINO,CA 95014-3255 ' (408)777-3228•FAX(408)777-3333•buildincit cupertino.orq Owner Name Pi(„11 Ole L t L C A Pennit No. /f 7 f`2/" Address A9 2 ,S / q o f r 1. 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. KNo 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 dumbing,installation of water-conserving plumbing fixtures is not technically feasible? Yes Civil Code Sections 1101.1 through 1101.8 do not apply. A The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. ❑ 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 fonn. '` No Go to Question 4. 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. Skip the rest of the form and sign bottom of form. XYes 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 four.. 5. 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 undergoesalterations 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 page. -----"' • Owner or Owner Agent's Signature: o ,u A Pi-.,it1«0 Date: .,iii/5` Upon completing and signing this Certificate,please return it to the Building Division in order to final your budding permit. SB4072015.doc revised 08/26/15 • I