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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 - building0cuo%r�tino.orn
Permit &o. lill 004-0
Z A M A r pr"Ve #-Qf Alarms Smoke: 'Qar�on Monoxide: 4 -Li
PURPOSE
This affidavit is a self -certification for the installation of an 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-fandly dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms, When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2,11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X.
On every level of a dwelling unit includ!ng basements
X
X
Within each sleeping room . —
I X
I
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-buming 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 9072.11.4 and 420.6.2. An electrical permit is required for
OaTms which must be connected to the building wiring.
As owner of the above -referenced property, I hereby Fertify 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.
! hptfe m_q(! ar?tl -9 6 fo nn-nly with tha forms and conditions of this statement
Owner (or Owner Agent's) Name:
J �A
Sig ........ ...... ............................................. Date:
ature .......... j .....
Contractor Name: V
Signature................................................................... L1c.# ...................................... Date: ...................
Smoke and COform.doe revised 03118114
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WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 building @cypprtino.om
- Je.
Owner Name 1AX, vi PerMit tjo.
V
Address CA / �_
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Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form.
Is your real property a registered historical site?
El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature: eAw-nIA vt__� Date:
[/No 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?
0 Yes Civil Code Sections 1101.1 through 1101.8 do notapply.
0 The licensed plumber's certification has been provided to the Building Division.
Sign below and skip the rest of the form.
Owner' Signature: Date:
dNo Go to Question 3.
3. Is water service permanently disconnected for your building?
El Yes Civil Code Secfions I 10 1. 1 through I 10 1.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature- Date:
eNo Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
0 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 test of the form.
Owner' Signature: V -P Date: 6 4OR It 5 -
dyes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections I 10 1. 1 through I 10 1.8 apply. Refer to the attached,
My property is a single-family residential real property. See Civil Code Section I 10 1.4.
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).
El 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).
0 My property is a commet-cial real property. See Civil Code. Section 110 1.5.
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 02104115
"'s
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).
VW% the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures Vill be replaced
prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections I 10 1. 1 through
1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation
requirements, and that the water-conservigg plumbiN fixtures corgply with the requirements as indicated in the table below. I
I Owner's (or Owner Agent's) Signature: MOM. IL - L_�/ , Date: z�/
Upon completing and signing this Certificate, please Meturri it to the Building Division in order to final your permit.
1. If the existing plumbing fixture water usage/flow rate is equal to orl6wer than the figure shown, it is not required to be upgraded.
SB407 2015. doc revised 02104115
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
Fixture Type
Maximum Water Usage/Flow Rate
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
Water Usage
/Flow Rate
2013 CALGreen Div. 4.3
20.13 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 gallonstflush
(Toilets)
Gallonstflush
Dual flush toilets: 1.28 gallonstflush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush)
Urinals
Exceed 1.0
Gallons/flush
0.5 gallonstflush
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
a- 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 orl6wer than the figure shown, it is not required to be upgraded.
SB407 2015. doc revised 02104115