S 2843 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PI7RM IT NO.
t BUILDING DIVISION APPLICATION/PERMITPLUMBING'..MECHANICAL
BUILDING PRgIBCP 11TVIFICATION
BUILD]NO ADDRESS: 14 00 r15,
SANITARY NO. A PLICATIO .U 1M1 1'AL DATE
o g g 5 Y t4ma rZ�.. a,2 Y 1 9
OWNF. ry li; PHONE: CONTRACTOR'S NAME: LIC NO:
P.em tQq
NiCONTROL#
ARCF GINEER: -.IWO ADDRESS: � � ..S
CONTAc : PHONE: BUILDING PERMITINFO
EJ Consultant Fees Paid by Applicant(Initial) carr, ELECT PLUMB MECB
�I— 0—
IC SEDCON dacal"S DECL....I CDN QTY. ELL'CTR IC PERM IT PEE
I
IBrnr that I tttn Boottsw anner pmvixh,na air Chapter 9(eantmof°1"g JOB DESCRIPTION
WO, withScdiun 7000) ED Div sinn3nf the Businessa omC Je,and my license is RES
F,�O fall force and aficO. w PERMIT ISSUANCE
RU, Liwrna ClassF y-//y1X',)')—Lic.N DWI. ❑KITCH17N REMODEL
tFaa Dam---6y%F%y�y---Commdor APPLIANCIiS-RESIDIiN'ItAI. - []ADDITION [:1 PLUMBING RGI'll'li
/ RCHITF:CPSDIiC 1R PANELS ❑MULTIUNF ❑$TRUCI'11RAI.
zOy4- tun rslanA my plans shall bensedaspubllcrecord's MODIFICATION
Oz-G UP'10200AMTS
1-K t:B1 Licensed Prolnsomal ❑IN'HHR10R ❑CHIMNHYRHPAIR
bCny�'4 OWNER BUILDER DECLARAI ION 201-100GAMPS IMPROVEMI;NI' SWIMMING POOLS
W I hereby nRnm that I am excerpt floor ton Cnnlrucmr'x Lieme a Low for'no OVER IWOAMPS ❑BATA REMODEL/REPAIR ❑DEMOLITION
�6U following reason.(Secular Business and'a'.simns Code:Any citym county ❑DT'1{lulu
'3 I- SIGNS FLEC'I'RICA).
LL m which captures o .fill,conswm,altar,improve,demolish.or repair any swcmrc
prior to its issuance,also requires the applicator for such permino tileasigned Hemmem SPECIAL CIRCUIT/MISC.
2; N dual he i x I leaded pursuant c hepmvisimns nl'the Cnnrrucmds License hnw(Chupler9
(LDC pp (rommencing with Semian]IXq)of Division:nf'he Business enA Pmfeasions Code)mr TEMP.METER OR POLEINST. R L•
'L y o C that he i%exempt therefrom and the basis for the alleged exemption Any violation(if El NB .DG/ADDITION El DEMOLITIONiWC ti�4. Section]11315 ermsu
by any applicant fora pit hjects the applieunl In a civil penally ICES til POWIiR DEV
not mote than five hundred dollars(SNEEEL DIF ANT E:1 FOOD SI?RVICE
FZG ❑1.a%owrcrof the properly,or my employees with wages as their sole cmr,amation, SWIMMING IDI,ELECTRIC IMPROVEMENT
will do tam work,and rhe snrmare is nal intended oroffemsl for sale(Sue.](W4,Bnsinesa ❑OTHER
a a and Professions Code:The Contractor's License Law does not apply to an owner of OGTLETS SWITCHES-FIX'TUNBS
progeny who builds or improves thereon,and who does such work himself or through
his own employees,provided that such improvements are not amended air offered for NEW ENTI ELECTR SQ FL /
role.IL loosest,the nuilJing or improvement is sold within one year nfcnmpletion,Ihc SQ.FP FLOOR AREA S/SQ.PI'.
.,act builder will have the btnen of pmving that he did not Wilder improve for pur-
on.oriole.).
e3 3 i S
❑ 1,as rwnar car the progeny,am cxclusively contracting with licensed Oadeact s m
construct
n the project(Sec.](414,Business and Profession,Cade:)The Cnnlmnor's Li.
cense Law does not apply to an owner of properly who builds or improves thereon.and QTY. P MBI .HMIT FEEwhoemnmmtsrorsuuh projects with nsrm'occulds)licensed punuan
no the C'onoaemr'e - `7 _
Lresm p law.
❑ PERIOD ISSUANCE /
I temundcrStt. ,11&PCfar this reason
ALTER-DRAIN&VENT-WATIJt(EA)
Owner Dam - 33 3;Ah 1TIGN
• WORKBR'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE: 36.
I herebm ena
y affirunder plty of perjury one of the following Jwlarations
�Ihavcand will imm�lainaCenilicnlcol Consent In aellinsura lice Worker's Cnmpcn- DRAINS-FLOOR,ROOM AREACONIJ,
1.1mr.as Provided for by Second 3](X)of the LuMr Cede,for the Inrfonnance of th ,e STORIES 'TYPE Co 'TRU ION
work fair which this permit is issued FIXTURES-PER TRAP "')
[_] 1 have and will maintain Worker's Compensation Insurance,us res,rial by Section (/
3700n1'the LaborCode.fnnhe p_rfoormareof the walk lin which his permit is issued. GAS-HA.SYS1 EM-1 INC.4 DU'1'LETS
My Workers Compensaion Insurance caincreased Policy number ore: OCC,GROUP APN
Cacao: Policy Na.: GAS-HA.SYSI'F,M-OVER 4 CA)
CERTIPICAI'I.OF EXEMPTION FROM WORKHRS'
COMPENSATION INSURANCE GREASP/INDUSTRL WASTE IWERCEPIDR
less.)
('Ibis section mainland recommitted mpitted final,permit is formic hundred dollars Lk 10() GREASETRAP
DIVISION FEES
or - -" '- -"
allied, ' K itis
Ioy any Persian
in any contero as t Isecome subjech ct
to the Worker'
pen-shall SEWER-SANITARY-,"
not employ any person in any manner vs as m henrme subject m the Worker:Cnmpcn- S IDRM Eq.200 PC CY .
O o .
Applicant' l WAI liIt HEATER W/VIN'DULECUt
Z
limon Laws f C,liforinDam
ADING PEE
Z^ NO.me subject
gPPLICAMD IL afar making this Ceni(icm of Exemption,you should
IF WATER SYSTEM/rREA'1'ING
a > ecame subject air the Wnrkcr'x Conlpamti
non pmvisinn.v offthe Labor Code,you must SAtiS FEE
LkJ fonhvull comply with such provisions orthis Le t shall be m
deeed revoked. Wq'TL'R SERVICE
d A
CONSTRUCTION LENDING AGENCY
t7Z NEW RESIDENTIAL PLMI3. SQ,FT. PAID
U kforwhich'his lobcteissmrmnac.ion landing agency for theryrl'nnnancenf Dns, ItcceiplN
1-' the work far which this pennil is issued(Sec.3097.Cie.CJ
Lenders Name
1..1Lender's Address TOTAL;
0. 1 certify tits'1 have mad this application and state that the chase foloA rriina is 'ffyfAL. BUILDING EE ��
Z,7 mount.Ingrceto comply won all city and county entrances and lots,laws relaringm QTY, MECHANICAL PERMIT FEE
UG ht liing conssweunn,anti[Qmby anthorim reprevenotti ves til'this city to enter upon the SCISMI FEE Q
above-mentioned pmpany for inspection purposesas
We)a PERMIT'ISSUANCE �`
1 gree m save,indemnify tad keep harmless the Cily accrue
Colman l id City ELE RIC F.E 6
liabilities,cncf it costs andexpensesworhich may in any way accrue against said City ALTERORADUTOMECH.
to comcyttcnce Trite granting oRhis Permit. I'LUMHIN( FEH
APPLICANT 1 DERSTANDS AND WILL COMPLY WITH ALL N)N- IN'f AIR HANDLING UNIT(TO 10.IXX1 CFM)
SOURCF I.ATIONS. MECHAN JALETE
2N1TIO'VLRDL INO UNITIOVER III,(XXI CPM) MECTIANSTI CTION TAX
tiignnturc of ApplicanUConlr.'cmr a
NITE
'f HOOD(W/DIICq HOUSING IGn'1'ION FIiIi
HAZARDOUS MATERIALS DISCLOSURIi
Will IFeapplicam or furore bmidiagaceupantsnaeorhardic hranlmns material UNIT('10100,BI%1 BTU)
as defined by the Cultivator Municipal Crile,Chapter 9.12,and the Health and Safety
Code,Section 25532m)7 fk/' ON(-[(OVER 11X),000 BTU)
E]Yes ' IVf�
Ko 'LION PAN(SINGLE BESIDE PAIDWill thea hard air fumrc huildin quip Dale Receipt Nc pp g by he Bay A c mum or devices which -COMP QHP OR 100,000 BTU)trait hunnslous air cnmm�dinm's err def neA by the Rny Arco Air Quulhy MttmgememOistrin! �����////N� TOT❑Yes / -COMP(OVER IOlying, 1'TU)I have read the Immedate andomils requirements under Chapter 695 ,1'he Cali. DITIONERforma Ilealtb Safcry COJcSre'iom 2350525513 d 255WiaISSUANCE,DATE
buildin6d rtcurtantlyhuvaamnant.the li rexrymsiM1iliryInnotifytLcup tit IDLNTIAL MIiCH. SQIT.build �IlItu ' nrtAam h it Bnrespon COdlitata In 5Owmermaut dleagenttc 'TOTAL: ISSl1F.D IIY:
OFFICE
riOV, 2, 1557 6 30i+M Ef I,Jki KHHGi iS FOLLK NO.476 F.22
: . Baan Kangas Faulk
Engineers • Suiveysu • Planners
•
November 1, 1999
96006950
Chuck Schoenberger
O'Brien Group
2001 Windward Way, Sults 100
San Mateo,CA 94404
Subjeat OakValley-Foundation Varlitcatlon
Dees Chuck
On October 25 and 28, 1999 and November 1, 1999 we performed survey of the locallgq of the
foundation forma for the buildings biting constructed on Lots 5.16 1.17 •18,5.19,and S.; 'of the Oak
Valley project In Cupardam
The yesula of that survey clearly she w that the location of the foundation forms aro coosutsnt and In
conformance with the dealgrt locaritm of the buildings,as,said locations ars shown on the plans prepared by
our firm.
7hIJ letter Is intended to provide you with the verification of those units per our survey, If there aro fitly
other questlans concerning that local Ion,please do not hesitate to call.
Sincerely, 1 AN0
' aRADLEYtiDILHO �
DR1A KANOAS FOGLIK ltl CN,3/31/02 q
BWloy A.811bo P.L.S.6141 Nj66141 w�
Project Manager Mr
Survey Dapemnent f`` Op CAUFO�
540 Price Avenues flechwod Cm,CA 84003 • (0501482VW a FAX 18 501 401-03 8 8
4 ENGINEERING WEST INC.
• OBSERVATION CHART
OAK VALLEY DEVELOPMENT CUPERTINO,CA.
6.1.2000 PAGE 2 OF 4
UWIT Lot Plan OPTION Fon. 1cl Moor oo Emely Sec.Mr.n1a, eab a.
5 1 1 3E 3 12569712 t0 07129199
S 2 BMR 0912169 NIA 2.8-2000 _2-1&2Q00 3-7-2000
5 3 BMR 09/21/99 NIA 2.8.2000 2.18.2000 3.7.2000
5 D4-29-99 07/01M 091246191 119 10101!09
5 S 6A 2IBONUS 04,29-99 06/17/99 0902199 0912269 10111/99
5 6 2A 1 04-29-99 06114/99 09/20/99 09/20/99 09/22/99
5 7 5C -I/BONUS111/ 09/1$/99 O I / 10/0199
5 8 28 3 04/1999 06/11/99 0910969 09/09199 08/24/99
5 9 30 2 04/1999 06/07199 09/0199 0910 .69 09/21199
5 10 8B 2/BONUS 04/1999 0512899 09103199 09/03199 •9 ! 9
5 " 4C 3 04.20.99 06/2799 06129/99 08/29199 09/28199
5, 12 D /B 1 52169 OB 319 115199
5 13 30 3/BONUS 0410199 052799 08/18199 08113/99 09103!99
5 11 6E 21BONUS 0410199 07102/99 08/18/99 08118199 06/29/99
5 1 A 3/B NUS 0410199 05/17 08110199 0802199 08123199
5 18 2C 11/0299 12.23.99 3.24.2000 3-24-2000 5.10.2000 4.27-2000
5'. - 17 4 11/ 12-23-99 •2 •2Q_2 '4
5 18 D 11/02199 12-15.99 3-8-2000 02-14-20005-1 .
5.10- 000 4.12.2000
5 19 eC 11/02/99 12.13-99 2.23.2000 1.21.2000 4.6.2000
5 20 3C 1110299 12/02/99 •18.20D0 1.20• 3.24-2000
5 21 5B ET,GAR, 0811899 10/14199 2.14.2000 -5.1 . 3.8.2000
5 22 7C 0811 / 9 O9 7 d. .a. 1.26.2000
5 23 1C 08/1899 09/17/99 1.20.2000 d,n.a. 1.21.2000
5 24 7A 2 0723199 10.4.99 1.18.20DO d.n,a. 1-21.2000
5 26
5 27 1.B 2 7 9 0612W9 101049 10104109 —10/11/s8
5 28 7B i 2 1 0510799 062999 10107/99 10/14/99 1011469
5 29 10 1 2 0510-09 07/0999 1011899 10/18/99 10118199
• 5 30 BMR
5 31 BMR
5 32 4A 9 72 10-22-99 10-22-99 10.27.99
5 33 2A 3 0510769 07/1299 11/0269 10.29.99 11.8.99
5 34 3B 2 06/0769 072369 1110869 12-1-90 12-1.99
5 I/BONUS05/2641907/26/99 11-10-99 11.10-99 12-8-99
5 36
5 37 C 0812369 728 B =1-!3;-2000
11-22-99 12.9.99
5 8 3E 2 0623199 081126912.2.99 12.14.99
5 39 5A 3 082399 08/186912.6-99 12.18.99
5 4 I NU 0710869 06112692.1 99 12.21.99
S 41 3A 0710899 0823199 1.3.2000 2.18.2000
'(1)LOT 6 PLAN 2A 6 LOT 7 PLAN 5C (4)A.B.'s at poron lront
*DID NOT OBSERVE PIERS. (5)chimneys
'(2)DBL SIDED SHEAR WALLS
(3)FLR. NAILING
•
ZO'd
019T 96Z 9017 1S3M ONYB33NTON3 VZVZO 00-ZO-unC
' ' BP EV
/GRo V L
sy
'•ke
T
Jim Rlploy(SMTPvlpIaydp®p aCWII,nol( —_
Monday, March 00, 1990 2;20 AM
•
PAT BUAKE
OAK VALLEY
ca
Llnoar parkway.planllnp,
S wllhln Ih• HAW park
n documanls prepared aro conSlSlonl wllh Ih0 lOnCa
dspO ^\
by Ihls ornca and rovlowod by Iho clly
ish
998 and eonlorm wIn$ prollminary approval doumonla,
9m Group, Inc,
E:r ,
FINAL PLANNING SIGN OFF ,
DATE �o
SIGNATURE
SIIITIIIDA,SAN MAtaQ fALINOHNIA711n1,1d7J TIMPHON8r61n)377,0300 FACS )49.2441
p.vl'.4 41
4rrh I, 1996 .:
POSTTHIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO PERMrr No.
BUILDING DIVISION21143
- IIUILUING PROJECT IUENT'IF'IG'f1O.
EUILDINUADDRESS, - SANITARY NII. APPLICATION SUBMI'"Al-I
OWNE 'N P • �PHONG CONTRACTOR'S NAML: LIC NO: 1
c-1. r/ _ NIC CONTROL##
• ARCGINF-ER: ADDRESS
'/ , ❑ � i J
fes- _Wa.Yav
BUILDING PERMIT INFO
INSPECTIONS DATE INSPEC, ❑ Consultant Fees Paid By Applicant(Initial) BLDG e1.ecT rl.umtl MECIt
FOUNDATION/PIERS/H.D.S. INSPECTION RECORD
JOB DESCRIPTION
UFER GROUND ( NOTE: ALL GRADING AND DRAINAGE
RESIDENTIAL:
PAD/SETBACK-CERT -� CL SHALL BE INSTALLED TO COMPLY WITH ❑SFDWL 0 KITCHEN REMOD
THE APPROVED PLANS AND CITY OF ❑ADDITION D PLUMBING RE-PIP
GARAGE SLABS/PREGUNITE CUPERTINO STANDARDS. DMULTFUNIT DSTRUCTURAL
POUR NO CONCRETE UNTIL A VE HAS BEEN SIGNED. MD
TO ARRANGE INSPECTION DINTERIOR ❑CHIMNEY
RRE N
EPAIR
IMPROVEMENT C]SWIMMING POOL;
UNDERGROUND/SLAB CALL AFTERNOONS (1:00 PM - 4:30 PM)
❑BATH REMOOEUREPAIR ❑DEMOLITION
PLUMBING 777-3228 MONDAY TO FRIDAY 24 HOURS BE- 0OTHER
ELECTRICAL FORE REQUIRED INSPECTION, JOB ADDRESS
DO NOT'FOUR-FLOOR UNTIL'ABOVE HAS.BEEN SIGNED AND PERMIT NAPE NEEDED WHEN PHONING.
COMMERCIAL:
PLUMBING - ATTENTION CONTRACTORS: DNEW BLOG/ADDITION DDEMOLII]ON
MECHANICAL NO PERSON(S)SHALL PERFORM WORK ON ❑TENANT ❑FOODSERVICE
THIS JOB SITE WITHOUT BEING IN COM- emENr
ELECTRICAL PLIANCE WITH WORKERS'COMPENSATION DOTHER
THER
FRAMING VENTS INSURANCE REQUIREMENTS.
INSULATION Q',7 INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE ws,
PLACE NO SUBFLOOR UNTB:ABOVE HAS BEEN SIGNED'
ROOF SHEATH/DIAPHRAM
PLUMBING
CAav Q12-
TUBS&SHOWER PAN Cif
MECHANICAL
ELECTRICAL/POOL BOND
FRAMING/STAIRS/E.EGRESS
I N S ULATI ON/VENTILATION
COVER NO WORK UNTIL'ABOVEHAS BEEN SIGNED
EXTERIAL SHEAR/HOLD DOWN
INTERIOR SHEARMOLD DOWN
SHEETWROCK/SHEETROCK SHEAR
EXTERIOR LATH/W-SCREED ..C,�(J`
SHOWER LATH 6
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED:
SCRATCH COAT C.X L&&:0 (f
SEWER/WATER kk
TEMPORARY.APPROVALS ,
OCCUPANCY
ELECTRICAL
GAS
GAS TEST
GRADE Z q 0e
FIRE
HANDICAP By
ELECTRICAL
PLUMBING
MECHANICAL -
ENERGY
• VISUAL FINAL ONLY CERTIFICATE OF OCCUPANCY
BUILDING IMPORTANT: ISSUANCE DAT. , ..
_OGOUPANCYtOPBUIL``,DING+I5(1;j0 tFHRmrrrE '=" EAD REVERSE SIDE BEFORE
UNTIL BIJILDNG FINA{ 11IIIS SIGNED$Y BUU D OR FINAL INSPECTION!!
J .
iNSPBCTQR�P I A; apv, wl„ ki KK`%'d,«�;" ISSUEDBY:
POSTING COPY
FROM CRIISJI FAX NO. : 8313358329 May. 26 2000 08:39AM P5
- _'k11i 01;1557 02: 70 40u33bu70: F!.liE: @8
I
CotemardAl Roof Mssagem of Satz, M,he.
• `, RaaidertudRmfSysurnbuqunonReport
4 et VAWW4 "W-j ISM ami l
Project: GMI"M� Inepectlon Dalai -2jEe&*-e -Acmup
101,48
Addreee;rt:•tea.ntadtr o(: City: cuportinp State; QA
Client-, nil O'afien Grouo
Contact: at Burke/Dan
Roofing Contractor._$j_17O—
CRM Inspector.
Lot Number:
Type of Inspection: Pell'' Final
Type of Roof: Shingle +� TUe Other ILV�A4 ae+%wetuar
Underlayment: *o Sht Metal Flashing: X„ Ruttere; —0.- Arm's 4,0SkyNahts: -4- A,ttaehments: Vents A Plpae: wwo*WU
Valleys: —A. Alld w -A- Eaves;jr.- Wp1p1�
• CommentalObaervadons:
FL-^t ►wa4s p&m'sata+c-a� �e.�zmtrti� ac7x.u..�o,
A -Ur aM4 4
.r-ft%f&AaWT.ua %S A-
C." Srlr1`t«+rµµf�.3ir St'7M.n.Mt w..f aa741"n4 d+�^t C�aa�_m.f9
N prw .
�.'141t1+WQ �11L+f. V10 6�
/k.. U44ECIC }1Me«�C"(• bjCW)t�kaAEUiR .
ae RldOut RaW4
•
coAsr Insulation Contractors, Inc. INSULATION CERTIFICATION
1086 N. 11th St. • San Jose, CA 95112
This is to certify that insulation has been installed in conformance with the current energy regulations,
California Administrative Code, Title 24, State of California, the building located at:
SITE ADDRESS: 5- 11 onkl U
FLOORS:
Manufacturer OWENS CORNING/MV Thickness/Type R-Value
EXTERIOR WALLS: 1
Manufacturer OWENS CORNING/MVThickness/Type R-Value h
CEILINGS: Q
BATTS: Manufacturer OWENS CORNING/MV Thickness/Type R-Value,
BLOWN: Manufacturer Ow N (/QORNIN • Thickness/Type R-Value
Weight/Bag 35 Sq. Ft. Covered # Bags Used
I
AIR INFILTRATION SEALANT INSTALLED:p�YES P§-- NO ❑
GENERAL CONTRACTOR (yejjrA/D LICENSE #
BY: TITLE: DATE
• COASINSULATION O RACTORS, INC. LICENSE # Q C.2
BY: E: DATE: AS--
:.INSTALLATION CERTIFICATE (page 1of 4) — CF-6R
t
We Address Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy,per Section 10-103(6).
HVAC SYSTEMS:
Heating Equipment
Equip, Aor Efficiency Duct Duct or Healing Heating
Type(pkg. CEC Certified Mrr Name Identical (AFUE,ete.)l Location Piping Load Capacity
heal um and Madel Number Systems [2CF-IR vaiuc attic etc. R-value (Btu/hr) Btu/hr
57 FOAM C WM IB 00ei2
Z.
ND _1- 910 .4771 _G -2A61
Cooling Equipment
Equip. CEC Certified Compressor 0 of Efficiency Duct Cooling Cooling.
Type(pkg. Unit Mfr Name and Identical (SEER,ete.)i Location Duct Load Capacity
*heat um Model Number System 2CF-IR value ani etc. R-value (Btu/hr) uithr
ND 1 Som �38GKGo30 �_ ' , n Rtf/G -
1. >_reads greater than or equal to.
1, the undersigned,verify that equipment listed above is: 1) is the actual equipment installed,2) equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-IR)submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
• manufactured devices(from the Appliance Efficiency Regulations or Part.6),where applicable. .
��ucwlc✓�:,n�ZT-S�r�
Signature,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name) OR Owner
WATER HF.ATIN . SYST .M :
Distribution If Recir- 0 o Rated' Tank Efi- External
Heatcr CEC Certified Mfr Type(Sid, culation, Identical Input(kW Volume ciency' Standby' Insulation
Type Name&Model Number Pointof--Use) Control Type Systems or Blu/hr) (gallons) (EF,RE) Lou(Y.) R-value
e
2 For small gas storage(rated input of less than or equal to 75,000 Blu/hr),electric resistance and heat pump water heaters,list Energy Factor.
For large gas storage water haters(rated input of greater than 75,000 Btu/hr),list Recovery Efficiency,Standby Lou and Rated Input.
For Instantaneous gas water heaters,list Recovery Efficiency and Rated Input
Faucets &Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6, Subchapter 2, Section
111.
1, the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the cettif(cate of compliance(Forth CF-IR) submitted for compliance with the
Energy Efficiency Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
a� Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
COPY TO: Building Department
Building Owner at Occupancy