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15090120CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10296 PLUM TREE LN CONTRACTOR: RAJA MOAZAM AND PERMIT NO: 15090120 JIANG YIMIN I OWNER'S NAME: RAJA MOAZAM AND JIANG YIMIN 110296 PLUM TREE LN I DATE ISSUED: 09/18/2015 1 OWNER'S PHONE: 4084310288 1 CUPERTINO, CA 95014 1 PHONE NO: 101 License Class Contractor LICENSED CONTRACTOR'S DECLARATION Lie. # Date 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: t. 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. 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 T OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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 s e (Sec.7044, Business & Professions Code) 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: t. 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 p it is issued. 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. Q---, Date 1?// e//�/ JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMOVE (E) ROOF AND INSTALL (N) 30# PAPER AND LIFETIME COMP. ASPHALT SHINGLES - 25 SQ'S Sq. Ft Floor Area: I Valuation: $9000 APN Number: 31633014.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSP jCT ONS .fi Issued by: �(�JL� Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: g �/ ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. O or authorized agent: Date:__%/ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed REROOF PERMIT APPLICATION X509000' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org PROJECT ADDRESS c� _ _ ^ _ / 1 � Z1 � f (.0 hAl I t I EG (-A-,r\1F APN # 1 I OVANER NAME PHON E-MAIL nnaAZ� w• ogp-y3 -�z8� r,,�,� —A l - c�t� q' STREET ADDRES$OZ4 1LL/I� -Till LW15 Cm CS-T69St� 1N G� 5-0/ ZIP FAX CONTACT NAME PHONE E-MAIL IV STREET ADDRESS CITY, S AZ E, ZIP FAX I❑ OR'NER K. OOWNER-BUILDER ❑ 01 R`NER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGE. r ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME A LICENSE NUMBER LICENSE TYPE BUS. LIC. ( K tonlC S 1a COMPANY NAME E-MAIL FAX STREET ADDRESS 1 9J L 1V a L CITY, STATE, ZIP MILt'r? S Get 5v 0? PHONE OKQ 4 ARCMTECTIENGINEER NAME LICENSE NUMBER BUS. LIC. k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family ROOFAREA: VALUATION: STRUCTURE: ❑ Commercial oP S Q, -too 0, 0 0 EXISTING ROOF TYPE: ❑ BUILT-UP ROOF P PASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTTER (SPECIFY) REMOVE /REPLACE DYES IFNO, I PLYWOOD ❑ '%n ❑ PLYWD ❑ OSB PITCH: ROOF nA ❑ NO 4"LAYERS: THICKNESS: ❑ 518" TYPE: ❑ CDX :12 LASS: VKq PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPO DESCRIPTION OF WORK: 'T — O M S ALL 30L -Ls fA _P F M — M 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 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 lavas relating to �)ding construction. I authorize representatives of Cupertino to enter the above-ident' led ro erty for inspection purposes. Signature ofApplicanUAgent: L - — — _ Date: - SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY If building is associated with a Home O,",ner's Association, provide letter �_ � ����`` ��T�'P> ��•ti ' a �a .:. ROUTING SLIP y O ER TI�CO. TER t bL�G _ of approval from HOA. PProya s. PLAN REVIEIV Provide Planning approval to verify if there any restrictions.�] ' $TRESS FL_ Tn G PLA _N RF\= Provide copy of Manufacturer's Installation Specifications. X01 _ �j �g;tfflT. Provide signed copy of Cupertino's Tear -Off Policy. IN" y Reroof4pp_2011.doc revised 03/16/11 CITY OF CUPERTINO 1509010110 Is M-1 FEE ESTIMATOR — BUILDING DIVISION ka,ADDRESS: 10296 Plum Tree Ln. DATE: 09/18/2015 REVIEWED BY: PAUL Week Permit F'ec. APN: 316 33 014 BP#: *VALUATION: 1$9,000 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: Plumb. A4fech.%Elec PENTAMATION 1SFDWLR00F PERMIT TYPE: WORK Remove E roof and Install N 30# paper and lifetime comp. asphalt shingles - 25 S 's SCOPE Suppl. Insp Fec FEE ID ROOF AREA s. f. 1REROOFFRES 2,500 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are horsed on the Dreliminary information available and are onlv an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E : 7/1/13,) dlech. Plan: Check Phrntfi. t'lan C'lu>ek E'lee. Plan Check Week Permit F'ec. Phan(, 1'eerrnit Fee: 1 lec. Permit Fee: rtrer i1k.r, r (}t" Ocher Elee. lush.Lj Plumb. A4fech.%Elec NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are horsed on the Dreliminary information available and are onlv an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E : 7/1/13,) FEE QTY/FEE MISC ITEMS Plait Check .Fee: Suppl. PC Fee Plumb. A4fech.%Elec Permit Fee: $4 Suppl. Insp Fec "lumb./Mech./Elec Plumb.4kch.iElec Permit Fee: C 'onstruction Tax: -ithninisl&itive Fee: Work Without Permit? 0 Yes (F) No $0.00 ,h,lvwnced Planning Fees: � 7 ravel Docurnenlalion Fc>c..' Strong Motion Fee: IBSEISMICR $1.17 Select an Administrative Item 1 .R Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $427.17 $0.00 TOTAL FEE: $ 7 Revised: 07/02/2015 le REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building gecupertino.ora 1►• S, d � / PL` A ` PROJECT ADDRESS® 2A(:;, t b �N f 10 / D� O\\NER1 AME Oft GL RA -JK PHONE 09 _ ��_ 02 8�8 E-MAIL STREET ADDRESS O ^ 1An CITY, U��ATE. ZIP �i0/ FAX CONTRACTOR NAME m LICENSE NUMBER 2Lt 0O LICFS)rE BUS. LIC. COMPANY NAME Ad -[14 le ! ,, / lr I E-MAIL FAX STREET ADDRESS 19 L A �OrJ �►Z CITY, STATE, ZIPM IC r/ 1. p PHONEy ! ' 2 2- 6,8_ s/ - I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2013 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30- 2:30pm (Friday) to schedule inspection. For Tear -Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs) and 7:3040:30am and 12:30-2:30 (Friday). Final Inspections will be given a two hour window. 3. Tear -Off Inspection is required. Any and all dry -rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked -down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. A Final Inspection and approval shall be obtained from the building inspector when the re -roofing is completed. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of I/4" per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre -manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. 7. NOTE: If you call for a tear -off or plywood nailing inspection and the work is not complete, you will be charged a re -inspection fee. The re -inspection fee shall be paid before another inspection can be scheduled. . By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxid etectors are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Co L —A Signature of Applicant/Agent: i Date: O IT ReroofPolicy_2014.doc revised 01/15/14 CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building CQcuoertino. org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS1 0 2q� APN(G vCJ OlI f - BP# OWNER NAME OWNER ADDRESS-. DESCRIPTION OF WORK: l m0 cc wk91l2. eK p6 25 7101% toM We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those icjuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injCtries to workers on my property. L2. I understand building permits are not required to be signed by property owners unless they are responsible for they construction and are not hiring a licensed Contractor to assume this responsibility. �3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 1L,< 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. �I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. L ---7'.'l understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. LSI understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 `�. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or v✓ww.cslb.ca.gov for more information about licensed contractors. 10 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. _Lzi . I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. �2. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information l have provided on this form. Licensed contractors are regulated by, laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint,.. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you -to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other venficatio acceptable to the city may be required to be presented when the permit is issued to verify the property owner's sigrz.6tVre. Property Owner's Signature: t -_-- Date: - -------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property ov✓ner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwneYBuilderForm 2010.doc revised 04/14/10 CUPERTINO PEP, VA I T R6 'Oc�•e, IS DW'V ft- CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: x,2 6 {�G�� 7" c.=€ �r�1�� PERMIT # 1 6-06 0 s—o o 2. OWNER'S NAME: PHONE # d ,5 � r GENERAL CONTRACTOR: f K, Ali BUSINESS LICENSE # ADDRESS: ,� L w o r�1 CITY/ZIPCODE: M (L p( S c* cJ o 3 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: ✓ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical -T ,k Y-- 4A „CIL— v iv Excavation Fencing Flooring / Carpeting ,,- © l41 Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing -T K ry Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature i 1�j Date WATER -CONSERVING PLUMBING FIXTURES FILIE OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION , 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 • buildinaCcbcupertino.oria Owner Name ir�t r Permit No:` "�� 66 6 ® ii�f Address 1 OAq bAm 7z Z",r- r AiE ,� iC 7—t 6 , 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? El YesCivil Code Sections -1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. ��T Owner' Signature: 1 _ Date: f 1116 "�-N0 Go to Question 2. l'"'� ( l 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? El 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: Y ` Date:.. l/C/�l r No Go to Question 3. - 3. Is water service permanently disconnected for your building? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the foam. Owner' Signature:_ Date: No Go to Question 4. 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 foam. Owner' Signature: Date: 1Iq El Yes My real property is built and available for use or occupancy on or before Januaiy 1 1994. ,Civil Code Sections 1101.1 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 pllumbing fixtures throughout the building. On or before January 1, 2017, all non-compliant plumbing fixtures shall be replaced with water'consezving plumbing fixtures (regardless of whether property undergoes alterations or improveiments). Myproperty 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. SB4072015.doc revised 02104/15 On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving --plum-bink fixtures throughout the building (regardless of whether; property undergoes alterations or 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 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 fixture Mply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature: - Date: Upon completing and signing this Certificate, please return it to the Building laivision in order to final your permit. i. H the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4072015.doe revised 02/04/15 Non -Compliant Water=Conserving Plumbing Fixture PlumbingFixture l (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 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 Gallons/flush 0.5 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 forlShowerheads (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, ano 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 td'6bh1eve reduction.,'. i. H the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4072015.doe revised 02/04/15