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15120029CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1007 SEPTEMBER DR CONTRACTOR: VALLEY HEATING & PERMIT NO: 15120029 COOLING OWNER'S NAME: SUN WERN-JIEH AND CHU TSENG TRUSTEE 1171 N 4TH ST DATE ISSUED: 12/03/2015 OWNER'S PHONE: 4088290747 SAN JOSE, CA 95112 PHONE NO: (408)294-6290 91LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ 1/0 License Class Lic. , REPLACE (E) FURNACE, SAME LOCATION & INSTALL (N) A/C UNIT IN YEAR YARD ' Z l / r Contractor/� Data —7/! 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 Sq. Ft Floor Area: Valuation: $16004 -performance of the work for which this permit is issued. ale and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36215016.00 Occupancy Type: ec ion 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 WITHIN OF IT 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 AYS FR ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of th Iss Date: 17- 3 granting of this permit. Additionally, the applicant understands and will comply with all non -poi _ source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. � Signature Date 213j�T 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(x) 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 505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: C� Date: ��/6 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 9.18. Signature Date PRODcCTADDPESSI C p� l� ��'T �'� I .4PNT IG z -(f fes' / 07NWERNA1J.'r GENERAL PERMIT APPLICATIONMEP STREET z DDR=SS d -l% .J e r 'T��^ CITY, STATE, E, ZIP 6 1 AW cry. C2 v R COMN/lUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ,` STREET ADDP.ESS F(� I S} CITY, AT=, ZIP FAX 10300 T ORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build inaQcuoertino.org CONTR4CTORNa.7,CE I LICE?:SE"R'3'BER �Cj P(J t CUPERT•INO C") E-NL4ILri'leC, /S/2�� STREET A DDRESS I �-7 p /I Cyf�� h S� CITY, STATE, ZIP ) 3S �2 El PLUI'�BING ❑MECHA1\ZCAL ELECTRICAL, ❑I;,,-ISCELLAu\t-0US ? PRODcCTADDPESSI C p� l� ��'T �'� I .4PNT IG z -(f fes' / 07NWERNA1J.'r STREET z DDR=SS d -l% .J e r 'T��^ CITY, STATE, E, ZIP CONTACT NAIME �p t I PHONE civ 21? (0 tel cry. C2 v R c ,` STREET ADDP.ESS F(� I S} CITY, AT=, ZIP FAX ❑ Ov"''IR ❑ ow,,—m-3=HK ❑ 0vr.�'-rMAGm-'T r CM. ACTOR ❑ CO?TRACTORAGE:T ❑ .4RC:TCT ❑ = GL\= t ❑ DEVELOPER ❑ i_?,Aj' CONTR4CTORNa.7,CE I LICE?:SE"R'3'BER �Cj P(J I LICENSE TYPE C J I BUS. LIC-4- IC-4,J C") E-NL4ILri'leC, FaX STREET A DDRESS I �-7 p /I Cyf�� h S� CITY, STATE, ZIP ) 3S �2 P n01\41'� Z t / 1, z `i b �/ ( ? .<.RCIETECTIFI -GTEER/NAI E LICENSE NU GER BUS. LIC CON3AINYN.-.ME E-NikiL I FAX STREEET ADDRESS I CITY, STATE, ZiP I PHONE USE Orr- ❑ SFD or DUPLE. ❑ )'RjLTI-F.4bG1-Y PROJECT IN WITr)LAI.TD ❑ YES PROiBCT IN ❑ YES IS THE BLDG AN ❑ '� :$ B Ul7 r' IG:13COI - ,MRCI� URB L� i 2FACB AREA ❑ No FLOOD ZONE El No EICFLE-RHO1J.E? E3 NO I DESCRIPTIO -NT �/ OF R -K e� / L 4 ..... . ....... . ... .......... . . ........... . TOTAL VALUATION: By my signature below, I certify to each of the followin g: Ian the -grope. ty o;vner or auuori�ed zaent to act on the prope, o;;per's be ave read this zpplication and the information I have provided is correct. I have read the Description of \Trork and ve a it is accurzte. I zgree to y with all applicable local ordinances and state laws relating to build'- construction. I authorize representatives of Cupe ting to enter ue abo idem 'r propel �y for inspection purposes. / Si /Agent: Date: amre ofA.pplicau SUPPLEMENTAL ENTT011UMATION REQULRED �FFZCELSEO>\Ll +,X;r Mp a� �s - OV£1,THE COi�3�R•. = ks} ' F 1A li 1 A S 4S zn 5 M. mRt AIFP , sc, pp_2011. do revised 06/21/11 CITY OF CUPERTINO Wwwil FRE ESTIMATOR — ]BUILDING DIVISION ADDRESS: 1007 SEPTEMBER DR DATE: 12/0312015 REVIEWED BY: MELISSA APN: 362 15 016 BP#: *VALUATION: 1$16,004 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex USE: PENTAMATION I FURN/AC PERMIT TYPE: A WORK REPLACE (E) FURNACE, SAME LOCATION & INSTALL (N) A/C UNIT IN YEAR YARD SCOPE perwif.f7ee., APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) IBREMAIR 1 # $72 Furnace, Forced -Air IMFR=<100 1 # $143 TOTALS: 1 $215.001.1 VOTE. 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 based on the preliminary information available and are only an estimate. Contact the Deptlor aadn't info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Mcin Check If'ee" Sipy)L PME Plan Check: $0.00 perwif.f7ee., Suppl' fhspfiee PME Unit Fee: $215.00 PME Permit Fee: $48.00 Administrative Fee: JADMIN $45.00' Work Without Permit? (D Yes @ No $0.00 Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEiSMICR $2.08 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 :SUBTOTA LST'$359.08 O. 1 $0.00 �'...:TTALYEE'. $359.08 Revised: 10/01/2015 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) - (Page 1 of 3 ) Project Name: 2015- 0406 Wern Sun Date Prepared: 2015-12-02 A. General Information CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit. 01 Project Name 2015- 0406 Wern Sun 02 Date Prepared 2015-12-02 03 Project Location 1007 September Drive 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 2015- 0406 Wern Sun 07 Zip Code 95014 08 Dwelling Unit Conditioned._ 1700 Floor Area (ft2) SC System SC System CFA served .systema rgfrigerant Number of space conditioning Insta{)frig 09 Climate Zone 4 10 (SC) systems in this dwelling 1 ducted containing ,F system more than 40 unit. entirely new B. Space Conditioning (SC) System Information W5. 01 02 03 04 ` FY 05 i 06 { 07 08 09 10 ,h =1s the SC Installing a SC System SC System CFA served .systema rgfrigerant lnstaII* neW SC Insta{)frig Installing Installing Identification or Location or Area by this SC ducted containing ,F system more than 40 entirely new entirely new Name Served System (ft2) . , system? component? components? feet of ducts? duct system? SC system? Alteration Type Furnace Altered space replacement add whole house 1700 Yes Yes Yes No No No conditioning system A/C C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) This section does not apply to this project. Registration Number: 215-A6425135A-000000000-0000 Registration Date/Time: 2015-12-02 15:54:45 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-02 15:53:41 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value Furnace replacement Central gas All new heating AFUE 0.96 Central split All new cooling SEER 16 Setback I Less than or equal to 40 R-6 add A/C furnace components AC components feet Required Documentation: MR -MCH -01-E - Space Conditioning Systems Ducts and Fans. -Duct insulation requirement for new plenums: R6. CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced. -Leakage rate compliance: <_ 15%, or 510% leakage to outside; or seal all accessible leaks. MR -MCH -25-H & MR -MCH -25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required wh. en MCH -25 is required Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt IF -",;,20 " 20 Duct Leakage Testing requirements %„ w -Heating-only systems and Air Handler/Furnace changes do not require venficati; of Air Flow MCH 23, or`Refngerent Charge MECH 25 -Existing duct systems constructed, insulated or sealed with asbestb are exempt,from MCH=20 Qui�t'Leekage Testing.€ qwr merits ,, E. Entirely New or Complete Replacement Duct System, with or without Equipment Cha ngeout (Sections.;150.2(b)iDua and 150.2(b)lE, F) ,1 s, This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 215-A6425135A-000000000-0000 Registration Date/Time: 2015-12-02 15:54:45 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-02 15:53:41 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Faulkner, Cindy C1�L000Cf� Company: Signature Date: ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING & ELECTRICAL 2015-12-02 15:54:45 Address: CEA/ HERS Certification Identification (if applicable): 1171 NORTH 4TH STREET City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 Responsible Person's Declaration statement ,. I certify the following under penalty of perjury, under the. ,laws :of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept.responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials components, and manufactured devices for thebuildmg design or,system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part,6of the California Code of Regulatlons. 4. The building design features or system design features identified ori this Certificate of Compliance are consistent with the unformation.provided on other applicable'cotnpliance documents, worksheets, calculations, plans and specifications submitted to the enforcementagencyforapprovai',wlfh this bwldmg permit application. 5. I that a registered copy of this Certificate of Corrlpliance shalt be;made a'vail'able wlthta b011dir g permit(s).issued fort4 building, and'made avatlable,tn,the°enforcement agency for all applicable will ensure inspections. I understand that a registered copy of this Certlf lcate of Cofnpliance is,regyired to Pip included with the;dacumentation the_ slider provides to,.the building owner at occupancy. Responsible Designer Name x ` 5 Responsible Designer Signature. — (ryj�p Faulkner, Cindy c�G�CG�f?.7LP/t' Company: Date Signed: ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING & ELECTRICAL 2015-12-02 15:54:45 Address: License: 1171 NORTH 4TH STREET 258540 City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6425135A-000000000-0000 Registration Date/Time: 2015-12-02 15:54:45 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-02 15:53:41 Schema Version: 0.555SDD f REVIF-V4'aD FU Reviewed {ti p C PLIOT PLANS CHECKED P�{ DAT LANNING DEPT CUPERTINO top" CiiPERTINO ,wilding pepanent �;vDE CCMPLIANCF- COMMUNITY DE 17LOPMENT DEPARTMENT BUILDING DIVISION - CUPER T INO A F^1 This set of plans and specifications MUST be kept at the job site d-urling construction. It is unlawful to snake any cha ng,,- c, or alterations on same, or to deviate th2ro corn, without approval from the Building Official. The st _;rnping of this r, :;- -: c specifications SHALL NOT bo rhni- to X '":"� " r'� ` ctn approval of t:1v VIOIati011 of a, ,. -v �; u. • "A;- Ordinance or State Law. DATE _ PERMIT NO. O 0 Z' lu��ffl I Q ;'t ;;f. SIVI*'KE I CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLUANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION LIMEA�C1�6�'1�3 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C (408)777-3228• FAX(408)777-3333• buildinq(a cupertino.orq � - % 200 2 7 '',.!:411 ft, 10° 7 S*l w►6pr 7l4a.. e: 5 Faitin ide: 1 PERMIT CANNOT BE F'INALED AND COMPLETED UNTIL TINS CERTIFICATE HAS:3ELN 1SIGNL1 AND WAD=TO'ITIS t irdD1NG-D.WI lON 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 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 X X bedroom(s) 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. t have read and agree to comply with the terms and conditions of this statement _ } ialC MetyI.sekntiV,IW53a VQhet rN 00.e" — tOIW L� 21d 1. Eotif abtii Name:: �I Si ati.fre_ 11167.0 Qat': Smoke and CO form.doc revised 03/18/1.4 `� ld: ., unint e �'Edt;1 �.rc-nvude�pm� i617III�F.� p"1�1•ApQllplii�f,� 1.Df'E ::A OWNER CE TI iICA1i OF COMPLIANCE • clt � COMMUNITY DEVELOPMENT,DEPARTMENT.BUILDING'DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014.3255 ' CUF'lEGB1Q ik0 I 1 ji 1 (408)777-3228 e FAX(408)777;3333.buildinq(a cupertino.orq Owner Name I I 'WP Y+j 02.1.1 SIA In , S/"2 O'2—''q . Permit No. ' �' ! Address ,' 6 , 'too 1 S ?p-�lr .1 /1�ve , 'taiNio' Ci tiro/se 1. Is your real property a registered historical s • ite? ❑ Yes' Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. `gi No Go to Question 2. I' 1 2. Does your real iproperty have a licensed plumber certifying that,due to,the age or configuration of the property or its plumbing,initallation of water-conserving plumbing fixtures is not technically feasible? ❑. Yes' Civil'Code Sections 1101.1 through,1101.8 do not apply. 0!'The licensed plumber's certification has been provided to the Building Division. Slap Itrestof th I Shee form and sign bottom of form. i No Go to Question 3. 3. Is water,serviceipermanently disconnected for your building? ❑ Yes: Civil•Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. I ,E4 tifl No , Go:to Question 4. 4. Is your real'p dperty built and available for use or occupancy on or before January 1, 1994? 0 No 1vly,it a1 property is built and available for use or occupancy after January 1, 1994. 11.: Civil`Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0 10.Yes 149 Yeal.property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign 1 , bottom of form.. II • 5. Please check ONE of the following: 1 • fp Ivtypropertylis a single-family residential real property. See Civil Code Section 1101.4. • On andafter January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures. ta;be replaced with water-conserving plumbing fixtures throughout.the building.On or before January 1,2017,all non- cotnpliai t1 plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether pr'operty'undergoes alterations or improvements). ❑ Myprop�erty is amultifamily 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). U Ivlypropettyis 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' fi tures 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 fltures'throughout the building(regardless of whether property undergoes alterations or improvements). I,as the owner.or owner's agent of this property,certify under penalty of per jury that non-compliant plumbing fixtures will be replaced prior Ito date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 • through 1104:.8.1,the.current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements, and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on:thee following page. ,., . iii iii I Owner or Owcte iAg,,ent's Signature '` — Date {t`' 12 q/i 1'Jpom co'mpl'eting and signing this Certificate,please return it to the Building Divisionin order to final your building permit. !, I SB4072015.doc revised 08/26/15 i '1 ;�1