Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
15040067CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10407 SOMERSET CT
CONTRACTOR: DAVE'S REMODELING
PERMIT NO: 15040067
INC
OWNER'S NAME: RODRIGUEZ JAMES J AND LORI
6001 TOPEKA DR
DATE ISSUED: 04/08/2015
OWNER'S PHONE: 4089739160
TARZANA, CA 91356
PHONE NO: (888) 216-3539
DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑
151,
LICENSED CONTRACTOR/'S
REMODEL MASTER BATH 45 SQ FT TO INCLUDE M,E,P'S
Z 14 V
License Class OJ Lic. # (o
Contractor ndl/L4 ��f � Date y_
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:
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.
Sq. Ft Floor Area:
Valuation: $7000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 36929032.00
Occupancy Type:
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
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITIiIN 180 D F ERMIT 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
180 DAYS F L ALLED INSPE T N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
City in of the
�,
costs, and expenses which may accrue against said consequence
Issued by: Date:
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
918.
RE -ROOFS:
Signature Date ` r
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.
❑ 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
1, 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(a) 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
of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
performance
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
T1 q �^
Owner or authorized agent: Date• —[ "a "t7
permit is issued.
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
I
I hereby affirm that there is a construction lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor Code, must
work's for which this permit is issued (Sec. 3097, Civ C.)
forthwith comply with such provisions or this permit shall be deemed revoked.
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I 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
918.
Signature Date
CUPERTINO
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a-)cupertino.org
"IVTSC
1
M NAMCFT .T .ANF.01 TS
YLUMI31Nli----
PROJECT ADDRESS l D q0 -}
`J C i7
APN # L-56 j 0-
OWNER NAME '
1Ae
PHONE
O
E-MAIL
�� L 4912 & �i
/�� ! L (O
STREET ADDRESS1 D u v O� e C^
T CT
CITY, STATE, ZIP ,. w c y Wo
(�
FAX
CONTACT NAME
PHONE
E MAH -
STREET ADDRESS
STATE, ZIP
FC,
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME✓�C �_ 5.��
P14Lr.
LICENSENUMBEi�i/ 7(���
j J
LICENSE TYPE
BUS. LIC#
COMPANY NAME V /� ` M - I n I J
DA Y I(�/:�JG•+C't
E-MAIL
FAX
r✓ CAWCTTY,
STREET ADDRESS
STATE, ZIP O
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY
PROJECT IN WILDLAND ❑YES
PROJECT IN YES
IS THE BLDG AN ❑ YES
❑ NO
BUILDING ❑ COMMERCIAL
URBAN INTERFACE AREA ❑ NO
FLOOD ZONE ElNO
EICHI.ER HOME?
DESCRIPTION OF WORK
p ��
TOTAL VALUATION :C,`EI�ED�BY
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I ave 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 construction. I author presentatives of Cupertino to enter the above -identified property. forinspection purposes.
`—./ Date: I L
Signature of Applicant/Agent:
SUPPLEMENTAL INFORMATION REQUIRED M-4en
EXe,:.EXPRESS�a MW
teMOOR'!
MEPMiseApp_2011.doc revised 06/21/11
Fr --,7,--7777—,1
CITY OF CUPERTINO
-.,�•.r r�cYmTwR 1 T/lll DTTTT 71TN!"_ 71TVTCTl11V
Mech. Plan Check
:Meeh. Perwit Pee:
Other Hoch. Insp.
Leech. hisp.Fee:
Plwtib. Plan Check
Plumb. Permit Fee:
Other Plumb Insp.
Elec..Plun (,.heck
I lec. Permit Fee
Other Diet^. Inst>,
Plumb. Insp. Fee: � Elec. Insp. Fee:
__z n_ rrr_-r_- c:... 0•...1t..r.. Q.,..,nr Wetrrrt .Vrhnni
NOTE: This estimate does not metuae fees aue to orner uepariffmrs" t,.c.. �u,.rrs, _ ���•� •• �• • _ _. _, ________, _
_ r_r r_ -__a .e.. ,mss:.., .in i-nntnrt tho none for addn'l info.
District, eta). Y7tese ees are oasea on env reeeii—gs,
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13)
1'L`ji LkyAAIV1A1Vi_
-- -----
____ ____ _____ -
MISC ITEMS
ADDRESS: 10407 SOMERSET CT
DATE: 04/08/2015
REVIEWED BY: MENDEZ
12
Remodel, Bath (<=300 sf)
1REMRESBAT
BP#:
"`VALUATION:
$7,000
hr's
APN:
PME Plan Check:
$0.00
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
SFD or Duplex
Permit Fee:
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
USE:
0.0
Jim
WORK I
REMODEL MASTER BATH 45 SQ FT TO INCLUDE M E P'S
SCOPE
$0.00
Mech. Plan Check
:Meeh. Perwit Pee:
Other Hoch. Insp.
Leech. hisp.Fee:
Plwtib. Plan Check
Plumb. Permit Fee:
Other Plumb Insp.
Elec..Plun (,.heck
I lec. Permit Fee
Other Diet^. Inst>,
Plumb. Insp. Fee: � Elec. Insp. Fee:
__z n_ rrr_-r_- c:... 0•...1t..r.. Q.,..,nr Wetrrrt .Vrhnni
NOTE: This estimate does not metuae fees aue to orner uepariffmrs" t,.c.. �u,.rrs, _ ���•� •• �• • _ _. _, ________, _
_ r_r r_ -__a .e.. ,mss:.., .in i-nntnrt tho none for addn'l info.
District, eta). Y7tese ees are oasea on env reeeii—gs,
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13)
on vrrsurw.o w.».»
FEE
.� »•__ _. _
QTY/FEE
____ ____ _____ -
MISC ITEMS
Plan Check Fee:
$0.00
45 1 s.f.
$645.00
Remodel, Bath (<=300 sf)
1REMRESBAT
Suppl. PC Fee: Q Reg. ®OT
0.0
hr's
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feel@ Reg. ® OT
0.0
Jim
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
C'onstrtwtion Tax:
'Idtninistrative Fee:
0
0
Work Without Permit? ® Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
Trm,el Documentation Fees:
Strong Motion Fee: IBSEISMICR
$0.91
0 #
$0.00
Revisions
1REvCoMT1 Tenant Improvement
Bldg_Stds Commission Fee: IBCBSC
$1.00
L FE
$645.00 TIA Eye
$646.91
Revised: 04/01/2015
kc,',", at the
—!".8 any
t
i,'IL NOT
C- c� "I v,
ui L -Y Ci�-- 0,
Yw
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10407 SOMERSET CT
CONTRACTOR: DAVE'S REMODELING
PERMIT NO: 15040067
INC
OWNER'S NAME: RODRIGUEZ JAMES J AND LORI
6001 TOPEKA DR
DATE ISSUED: 04/08/2015
OMWER'S PHONE: 4089739160
TARZANA, CA 91356
PHONE NO: (888) 216-3539
C7 LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL 0
REMODEL GUEST BATHROOM 45SQ FT TO INCLUDE
License Class 13 Lic. # �l0 Z 7' K
M,E,P'S
gee # 4
�W4 p„1 �,_ A 1,� �3
REVISION #1 REMODEL MASTER BATH 32.5 SQFT- ISSD
Contractor Date L
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:
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
—00
Ft Floor Area:
Valuation: $7000
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insuran
tAPN
Section 3700 of the Labor Code, for the performance of which this
Number: 36929032.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN PERMIT 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
180 DAYS INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
TCALLED
costs, and expenses which may accrue against said City in consequence of the
4131
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
918.
_ 13
RE -ROOFS:
Signature Date
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.
❑ 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)
I, 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(a) 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, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: ^1
permit is issued.
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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I 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
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I 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
918.
Signature Date
CUPERTINO
❑ NEW CONSTRUCTION
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1 Vim'
(408) 777-3228 • FAX (408) 777-3333 • buildiinn �cu ertino.or I t
El ADDITION ❑ ALTERATION / TI LJ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS
APN # ,10 q o
V
OWNER NAME ©,n ! `
fLa Lt
/
PHONE t;./QI / E-MAIL'
` (�
STREET ADDRESS
CITY, STATE, Z_IPZ
FAX
CONTACT NAME
PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ COMMCTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMEDAVE, �fL
LICENSE NUMBE e
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 I90 Aue- ( A I �e
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
I
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
DETACH
I
IGARAGEAREA:
❑ AT TACH
# DWELLING UNITS:
ISA SECOND UNrr ❑ YES
SECOND STORY EYES
""DED? []NO
ADDITION? ❑NO
PRE -APPLICATION [3YES IF YES, PROVIDE COPY OF
PLANNING APPL # PLANNING APPROVAL LETTER
IS THE BLDG AN [3YES
EICHLER HOME? NO
,RECEIVED>$X ' - s� .I -'=
TOTAL VALUATION:
[]NO
❑
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on t e property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize sentatives of Cupertino to enter the above -identified property for inspee purposes.
Signature of Applicant/Agent: Date: S
SUPPLEMENTAL INFORMATION REQUIRED
�� : dp
oIJiTIc
C> CTYPE,=
5 s'
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance ofbuilding
�,
I] OVER-TH&COUN 'E _
��w
SIR—* t.
❑ BUII DING PLAN REVIEA
f
Permit for new building.
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if any Hazardous Materials are being used as part of this project.HE
�RPRES � 4 t
�r.3vAAxD�
3 r PL �I t:PLANRES�W _
u BLicwoics
_ Copy of Planning Approval Letter or Meeting with Planning prior to
Building Permit
10
��
�1VTfARY SER ER nISI Rr
submittal of application.
01
ENVIROIYMENTAlHEA"TA<. .,.'
BIdgApp_2011.doc revised 06/21/11
i3�� ��o�I
19 1
�� I��
VZ6.
or
FtE1[I$�ON # -
"UPERTINO
Department
t Rm —OMPLIANCE
e
ewed By: �C.;
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 • buildingaQcupertino.org
10 �16 `7 Som► - c� Com-
rms
<J,400 1-7
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 CSC 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 ii 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 dwellin 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 comply with the terms and conditions of this statement
0(or Owner Agent's) Name:
/
Si na'tur........— ........................ Date: ................ .
Contractor
dQl1
. Sign , .................Lc# .............. Date: .��..
Smoke and CO farm. doe revised 03/18/14
IN
rp
I COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPERTINO
e-
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
1 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228• (408) 7Ai7-3333%-building(a�cupertino.org
L-11:1 `' i" ) `0`07"'\ CT ►� �2 Permit No.
s�Il®a � 7
Addy ^ /• �7" D-.� Sn �-� �� � G -i- C -- '. �{- ,,-� � �- .. - --
4 �F PE1221VIIT C�ANNO"�yBFsFINALED}.-A�VD�COIYrPI�E�'�D TJl\TTIL T�IIS CERTXFICATEu
`�' � '��•. � e-,��, �Y i. � �,r"x-' s s- �- � q �h. � �� � �, � -�' ,ate .� �+ ,aa,•� Ems, z�s .. ..
- �4 � ''�' .w.i 'kms". .,.�.< ..ver �..v'L.•..,o'4L� •`�"�,a..�""p,., .thus` `.��"��, `'r. ��n' �w�m,.-..—.�.e,..�-�..,.w..»��...�w I`�`�..,.��•• .?.,..,,.-....-s}5�..�+. ..
Phase refer to the attached California Civil Code Sections 110 1. 1 1101.8 which are part of this Certification form. .
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' Signatu:
Go to Question
your real property have a licensed plumber certifying that, due to the age or configuration of the properly or its
ging, installation of water -conserving plumbing fixtures is not technically feasible?
;s 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' SignatureC
Go to Question 3.
service permanently disconnected for your building?
Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature:"�
Go to Question 4.
real property built and available for use or occupancy on or before January 1, 1994?
My real property is built and available for use 'or occupancy after January 1, 1994.
Civil Code Sections 111001.1 thro 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature: C// "� Date:
My real property is built and availa le�se or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached.
M, property is a single fanzily residential real property. See Civil Code Section 1101.4.
0rjand after January 1, 2014, building alterations or unprovements shall require all non-compliant plumbing
fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1,
20 11, all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless
of 2,hether property undergoes alterations or improvements).
My, property is a zzzultifamily residential real properly. See Civil Code Section 1101.5.
Onvd after January 1, 2014, specified building alterations or improvements shall require non- compliant
plus= Bing fixtures to be replaced with water -conserving plumbing fixtures.
On 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).
Myproperty is a commercial real property. See Civil Code Section 1101.5.
On a�1d 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 03/18/14
4 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).
UWe, 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 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-consprving=glu nb�n�rig fi iia s complyXigrflif requirements as indicated in the table below.
Owner's (or Me igen s} Signature:
Up,,Upag, oomr le ' grand sigiiiia"g�this ifi it to the Building Division in order to final your permit.
_.
.- Noh-Compliant
:._.. Water -Conserving Plumbing Fixture_
Rlumbin Fixture,
(Fixture Complying with Current Code A licable to New..
PP Construction )
Maximum Water Usage/Flow Rate
Fixture Type
-
Wafer 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-CALG'reen 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 03/18/14