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15070195CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11718 RIDGE CREEK CT CONTRACTOR: SOLARCITY PERMIT NO: 15070195 OWNER'S NAME: WANG RODNEY AND WU YIHUA 3055 CLEARVIEW WAY DATE ISSUED: 07/31/2015 O ER'S PHONE: 3103508410 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] INSTALL 20 ROOF TOP, FLUSH MOUNTED PV MODULES License Class C �C?g Ci -LO Lic. # C (5,2 r� Contractor Ka i n f 0. } Date t0 i " 1 , � KW)I hereby affirm that I am licensee 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 Sq. Ft Floor Area: Valuation: $11000 performance of the work for which this permit is issued. 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. APN Number: 36604074.00 Occupancy Type: 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 to building construction, and hereby authorize representatives of this city to enter WITHIN PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save AY LED INSPECTION. 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 I ed by: with all non -point source regul� 'ons fr the Cupertino Municipal Code, Section /� 1 9.18. y Signature Date T 1/1 RE -ROOFS: , -5 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will 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 unifpal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505,2 33 46d 25534. Section 3700 of the Labor Code, for the performance of the work for which this `f `js permit is issued. Owner or authorized agent: t_, Date: 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the 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 9.18. Signature Date CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION O;.'};','1 i -"AE 77 7-3226 • t" i, �ll.i, r : " ,,Uil Tf z�1'"r.-L`J.JI�i-I' 71' G�t:il PROJECT ADDRESS i 1 ` Q� 1 r�� ' �� -�� 1 ' • APN # / a OWNER NAME GZ� G� �y j (�S PHONE �� S C ^ i, E-MAIL STREET ADDRESS � � i r� �� CITY, STATE, ZIP � LVI, i t e -A q5o I q FAX f E-MA1mjavanmard@solarcity.com CONTACT NAME Marjan Javanmard PHGNE650.477.6430 STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ®❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAMESOIarClty Corporation LICENSE NUMBER 888104 LICENSETYPEC10 BUS.L'cP28840 COMPANY NAME SolarCity Corporation E-MAIL mjavanmard@solarcity.com FAX STREETADDRESS391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 ""650.477.6430 ARCHITECT/ENGFNEER NAME LICENSE NUMBER BUS. LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE of SFD or Duplex [:] Multi -Family PROJECT N SVILDLAND PROJECT N Commercial URBAN INTERFACE AREA [I Yes El No FLOOD ZONE ❑ Yes F-1No STRUCTURE: ❑ SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NU`?v1BER OF PANELS/UMTS: C% KILOWATTS (COMMERCIAL ONLY): , j - L TOTAL VALUATION' DESCRIPTION OF WORK Installation (&2) rooftop flush mounted solar panel (5- �_) kW �prop rtyowner or authorized age act on the ro r s behalf. I have read thI By my signature below, I certify to each of the following: I a�a,�,' application and the information I have provided is correct. I head e Description of Worlc and verify it is a agree to comply with all applicable Iota ordinances and state laws relating to building construction. I esentatives of Cupertino to enter the above -identified property for in section purposes. Signature of Appl icant/Agent: Date: �v - SUPPLEMENT INFORMATION REQUIRED OFFICE USE ONLY ❑ OVER-THr-COUNTER v ❑ EXPRESS Xv U ca ❑ STANDARD U 2 ❑ LARGE e, ❑ MAJOR Mpp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION imlADDRESS: 11718 RIDGE CREEK CT DATE: 07/27/2015 REVIEWED BY: MELISSA n:,'. .' APN: 366 04 074 BP#: �'� ' S *VALUATION: $11,000 ^PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex 7PERMIT ENTAMATION SOLAR -REUSE: TYPE: WORK INSTALL 20 ROOF TOP FLUSH MOUNTED PV MODULES 5.2 kW SCOPE .1 A, ✓. f:3i..r. i,5t F 88: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, ripe, 3antraiy newer Lastricy acnooc T:..�.. -4-1 Tl. c h.. .,d ., #I.- —d aro n"h) an o0i'mate_ t'nntart the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS n:,'. .' Plan Check Fee: $0.00 illy 7 r3i �"' t'r`di<:::.. :zli7 E.: P, e(.n Alternative Energy System 1PHOTOVRES Photovoltaic System ... 1': iii .f'• {.. G'(a� $0.00 PME Plan Check: .1 A, ✓. f:3i..r. i,5t F 88: ")' 'Si!/%. 7'�e)�; jiit I'C. r :tr. Permit Fee: $0.00 Suppl. Insp. Fee -(E) Reg. 0 �'ii C. .' l 3' ' .. 'C.. � L'.'rii;i I°c'c. 0,0 ETph"';Lh,f7so $0.00 PME Unit Fee: $0.00 PME Permit Fee: O,ti E:+' (.xonttr'itt(ion Tax: ?i j?BPiYti.i'lP'ttfl c' 7'£'E:' 0 E) Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 A fech, hZ3 P r*c' E) 0 ./jyi;SYrL:. {i:.ifl. %.�CC: 1:;?.(;. 1BSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, ripe, 3antraiy newer Lastricy acnooc T:..�.. -4-1 Tl. c h.. .,d ., #I.- —d aro n"h) an o0i'mate_ t'nntart the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 C # $236.00 Alternative Energy System 1PHOTOVRES Photovoltaic System Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -(E) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.xonttr'itt(ion Tax: ?i j?BPiYti.i'lP'ttfl c' 7'£'E:' 0 E) Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 1 Strong Motion Fee: 1BSEISMICR $1.43 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 :'SUBTOTALS: $2.43 $236.00 „ ; TOTAL FEE;, $238.43 Revised: 07/02/2015 July 8, 2015 ►�701�� COMMUNITY MANAGEMENT SERVICES, INCORPORATED Rodney Wang Yihua Wu 11718 Ridge Creek Court Cupertino, CA 95014 Re: -. SEVEN SPRINGS OWNERS -ASSOCIATIONS 11718 Ridge Creek.Court Dear Homeowners: Enclosed you will fmd a copy of your Architecture Application for the residing of your home, with the approval from the Board of Directors, as well as any restrictions or conditions that the Board deemed necessary. According to your application you will be residing with the "Hardiplank Select Cedarmill" (Wood Grain Finish), and the installation of Solar Panels on the roof at the back of the home. Please fill out and return the included final completion form which will begin the completion process. Please keep in mind that any deviation from your approved application will require you to resubmit your application for review. If you utilize an unapproved material you will be required to remove and replace the material with an approved selection. The approval of your project's architectural compatibility with the Seven Springs Owners' Association's complex does not constitute or imply, that the Architectural Committee and/or the Association Board of Directors deem your project as meeting City of Cupertino /County of Santa Clara codes. The approval is given contingent upon you and /or your contractor(s) obtaining the required construction permits and meeting all code requirements, if any. . Sincerely, Community Inc. `edia,`Senjssociation Manager; CCAM SPRINGS OWNERS ASSOCIATIONS LH/nm cc: Board of Directors File #4 & #16 1935 Dry Creek Road, Suite 203 • Campbell CA 9 95008-3631 • voice (408) 559-1977 . fax (408) 559-1970 Seven Springs Owners Association Application for Approval of Architectural Change/Addition CATEGORY C Category C -Modifications that are exterior modifications with no changes to the original building structure or floor plan. All roofing, siding, windowmaterial change, exterior paint color change, addition of a roof attic fan, or garage door', fall into this category. Date: �I b / Request for Approval of Proposed Change PLEASE PRINT THE FOLLOWING INFORMATION Name: h fAA kA Address: 117/9 R J M Cr a ct Home Phone:.J 3 16 : 0 Work Phone: email: rod @$ VL . tom Description of Proposed Change; 1) Paint Color Change. Please choose from "approved list" (Garage door 'ter should iamond white or frost) Ne►v Exterior Siding Color & Garage door(s) - same color, specified color 4`4,f 1! -Trim color: diamond white X or frost _ Fronf door coror: diamond whit`s natural oakor specified "approved color" "b d h - — 2) Roofing Material Change (please check one choice) a. Lightweight Concrete Tile from MonierLifetile - style "Cedarlite'5780", color "Muirwood" b. GAF Laminated Fiberglass Asphalt - style "Grand Canyon", color "Mission Brown" c. GAF Laminated Fiberglass Asphalt - style "Grand Canyon", color " "Stonewood" d. Decra Stone Coated Steel Rood System- style "Decca Shake", color "Shadowood" e. Class "A" Fire Retardant Roofing System using pressured treated cedar wood shingles with fire retardant fiberglass cap sheet underlay. Need to have a City of Cupertino Permit accompanying is application for all wood shingle roofs. 3) Siding Material Change (Please check one choice) Siding Material: Hardiplank Cedarmill (wood grain finish) or Hardiplank Smgoth Finish Which.sides are you are changing material? (front back _left _ right 470 ) 4) Window Material and Design change: (Please check this box): Vinyl Windows - color White *Must include manufacture also include cut sheet for type and style of windows. Retrofit New Constr 5) Adding a roof attic fan, Tubular Skylight, Air Conditioner. (location of Condenser), and Satellite Dish' Please attach information regarding the proposed change Application must include dimension, color of the proposed fan and its location on the roof. Please include detailed drawings, specifications, and product brochures if available. Tubular skylight up to 14 " diameter, one roof attic fan up to 26" in width & height -paint to match roof 6) Garage doors: a. Recessed wood panel, not raised in center same style for windows (PLAIN'- non decorative) Style 84 (8 panels across, 64 (6 panels across), 44 (4 panels across). Style _:with windows or Style-_ no windows b. Insulated wood, insulated metal w/ wood facing or "Carriage House" style 303C windows _ 303 no window _ 7) Solar System:.Adding solar panels to the roof of home. / (Requires drawing indicating placement of panels and photo for type of panel to be installed) 1 Homeowner's Signature: The request is in compliance with Seve prings HOA Arc a uidelines: http://seven-springs.org/files/architectual-guidelines.pdf Architectural Control Committee/Board: Approved �n g Denied Pending Architectural Control Committee Board: SignatureA-�10"_ ��! Date: ,7' 1.27.11 cat C FMMOf Hr L 11716 Ridge Creek Ct Ow Ws Obligations Nate System Sia: 5.2 kW System Production: 6503.37 k% kWhAYL 1250.65 k%h/kW Usage Offset: 77.04 R Unused Nnmtktg Planes NPI, NP Too.SmoO for Wmum $ of Modules UPI Poor Solar Access MP4: Not Enough Sgace Due To Fre SetDodo LEGEND (E) UTILITY METER s WARMNO LABEL O INVERTER W/ INTEGRATED DC DISCO at WARNING LABELS 69 DC DISCONNECT ✓k WARNING LABELS w AC DISCONNECT & WARNING LABELS O --OC-dUNCTI6N/OOM81NfR'80x� & LAMS - NO UISYROUTION PANEL aid LABELS Q LOAD CENTER At WABfM LABELS O DEDICATED PV SYSTEM METER O STANDOFF LOCATIONS CONDU T RUN ON EXTERIOR --- CONDUT RUN ON INTERIOR CATEITENCE O HEAT PROUCING VENTS ARE RED inti '� NIERIDIf EOUFMENT IS DASHED SnE PLAN NS CUPERTI!NO Owner N. Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildinq(akuper ino.orq FILE Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: QeNo Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. Owner' Signature: Date: (% L�' No Go to Question 3.f/ 0 Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: 2 --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. Sign below and skip the rest of the form. Owner' Signature: Date: CYYes My real property is bui t and ailabKorusor occupancy on or before January 1, 1994. J Civil Code Sections 1101. through 1101.8 apply. Refer to the attached. ("My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. SB407 2015.doc revised 02/04/15 On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I/We, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 tlu-ough 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation reauirements. and that the water-conservinsz plumbin4 fixtures comply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature:0t�l�' &,a, kzz- � Date: 9-11 -/5 1 Upon completing and signing this Certificate, Oease return it to the Building Division in order to final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015. doe revised 02104115 Non -Compliant Water -Conserving Plumbing Fixture PlumbingFixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015. doe revised 02104115 SMOKE / CARBON MONOXIDE ALARMS IPA OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildinaQcuoertino.ora r Q � / Permit No. �.�b �� 1 �� Address i' ! O s �G1 P Cr��/1 �L # of Alarms Smoke: s Carbon Monoxide 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 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 8314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: _ AREA _ SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X _ On every level of a dwelling unit including_basements X X Within each sleeping room _ X _ Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached. garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and. in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: r1 1ki 41 Signatw .................................. Date: Contractor N e: Sinature ........................ ........ ................................... 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