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15110050En FL -11 00 r Mi CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10581 CASTINE AVE CONTRACTOR: ANNE JOSHI AND PERMIT NO: 15110050 KUSUMA OWNER'S NAME: ANNE JOSHI AND KUSUMA 10581 CASTINE AVE DATE ISSUED: 11/09/2015 OWNER'S PHONE: 4086052953 CUPERTINO, CA 95015-0712 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic. # INSTALL (16) ROOFTOP FLUSH MOUNTED SOLAR PANELS (4.16 KW) Contractor 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: 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: $20000 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 APN Number: 32644033.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT E3WIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF 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 FROM LAST CALLED 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 f (ni (I granting of this permit. Additionally, the applicant understands and will comply Issued by: Y Date: I( with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 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. Or OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of t ollowing two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER , 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) 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 - ol 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 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. 1 Section 3700 of the Labor Code, for the performance of the work for which this ® (( I Owner agdnt: Dare: permit is issued. or authorized 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 i 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 1 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.I8, Signature_-` ALTERNATIVE ENERGY PERMIT APPLICATION! COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildincl(rDcugertino.org 151100 PROJECT ADDRESS/f C. Gt,S j"e, //"I Ve +�G�e/���00164 APN n ( L % `4 " O Cp — OWNER NAME JCS✓FAL A tiVJPi PHONE o o a Z�"I J E o -JH A C4Nt STREET ADDRESS/ O �] Lias � 11N e JL e CITY, STATE, ZIP%O �! , D ' CA -75'o1 � FAX Iff'1� CONTACT NAME PHONE I_ O "tr" ` l STREET ADDRESS PoLLAJ e& �-❑ FAX CITY, STATE,,,ZIP �,,,�,� 3 �^/ FAX � J owNaR ;&o%vNER-BUILDER El OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT El .ARCI,=.CT ❑ ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENU14BER LICENSETYPE I BUS. LIC 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NA1,4E I LICENSE NUMBER BUS. LIC R COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE I USE of ❑ - SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ COnnnercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ No SOLAR PANELS ❑ ELECTRIC VEHICLE CYARGING STATION 7 ❑ SOLAR wATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: KILOWATTS (CO'` IAERCIAL ONLY): TOTAL VALUATI o00 DESCRIPTION OF WORK , �>c b S s���-tr ✓b ,L liner� "k - RE EC IVSD BX 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. IW,e. 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 representatives of Cupertino to enter the above -id tified property for inspection purposes. 117 SignatureofApplicant/Agent: Date: SUPPLEMENTAL INTFORMATION REQUIRED _` OF$TCEt3S 0 LY.w I h' v. jr 7 OVERTH1rC0UNTET2: R�.'fFS� W. .�� -�ST41)D1RIly M$F L> naa PM4pp_2011.doc revised 03/16/11 0 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 10681 Castine Ave DATE: 11/09/2016 REVIEWED BY: Phuong llech. Permit Fee: l APN: 326-44-033 BP#: *VALUATION: 1$20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plumb. Lisp. Fee: PENTAMATION SOLAR -RES PERMIT TYPE: WORK Install 16 rooftop flush mounted solar panels 4.16 K SCOPE } A Mech. Plan (:heck Phunb. Plan (.heck Elea Plan Check llech. Permit Fee: Plumb. Permit Fee: Elec. Permit Fee.- ee:Other Other:llech. Insp.E1__L_ Other Plumb Insp. Other Elec. Inrp.Li :Lliech. Insp. Fee: Plumb. Lisp. Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the prefimina information available and are only an estimate Contact the Dept for addn'1 info, FEE ITEMS (Fee Resolution 11-053 f . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $236.00 Alternative Energy System 1PHOTOVRES Photovoltaic System Suppl. PC Fee: (j) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -Q) Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tar: Administrative Fee: 0 Work Without Permit? 0 Yes (S) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 Travel Documentation Fees: Strong Motion Fee: 1BSEISMICR $2.60 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $3.60 $236.00 ,TOTAL FEE: $239.60 Revised: 10/01/2015 TJ% i 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 (acuDertino.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 ADDRESS �© _C's,T . J — ,/._ ..... i. BPS l <lC�v�y� OWNER NAME .OWNER ADDRESS- - C� 2=� i=./ A -16V` DESCRIPTION OF WORK: 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.) z1. 1 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 injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. f 2-. I understand. building permits are not required to be signed by property owners unless they are responsible .for the construction and are not hiring a licensed Contractor to assume this responsibility. V 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. 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. V 5. 1 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. 6. 1 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 m' eto serious financial risk. et 7. 1 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. v 8. 1 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 f 9. 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 www.csib.ca.gov for more information about licensed contractors. 410. 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. 1. 1 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. V12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information - I -have - provided on this form. Licensed contractors are regulated bylaws 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 financialloss you may sustain as a. result of a complaint -Your only remedy against unlicensed Contractors maybe in civil court. Itis 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 jrou*obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or note 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 drivers 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 owners signature. Property Owner's Signature: Date: 11 - ------------------------------------------------------------------------------------------------------------------------------------------ -- (NOTE: The following Authorization Form is required to be completed by the property ov✓neronly 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 owners drivers 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: D ate: OwnerBuilderForm 2010.doc revised 04119/10 The new Q.PRO-G4 is the result of the continued evolution of our Q.PRO family. Thanks to improved power yield, excellent reliability, and high- level operational safety, the new 1PRO-134 generates electricity at a low cost (LCOE) and is suitable for a wide range of applications. GLOW LEVELIZED COST OF ELECTRICITY Higher yield per surface area and lower BOS costs thanks to higher power classes and an efficiency rate of up to 16.2 %. INNOVATIVE ALL-WEATHER TECHNOLOGY Optimal yields, whatever the weather with excellent low -light and temperature behaviour. ENDURING HIGH PERFORMANCE 11� Long-term yield security with Anti -PID Technology', Hot -Spot -Protect and Traceable Quality Tra.QTM. LIGHT -WEIGHT QUALITY FRAME High-tech aluminium alloy frame, certified for high snow (5400 Pa) and wind loads (4000 Pa). MAXIMUM COST REDUCTIONS Up to 10 % lower logistics costs due to higher module capacity per box. ® SAFE ELECTRONICS Protection against short circuits and thermally induced power losses due to breathable junction box and welded cables. A RELIABLE INVESTMENT Inclusive 12 -year product warranty and 25 -year linear performance guarantee 2. THE IDEAL SOLUTION FOR: Rooftop arrays on ,� Rooftop arrays on Ground -mo urded 13residential buildinEs �� commercial/industrial solar power plants buildings Engineered in Germany OCELLS MELD suuwn �-TOP-BRAND nPV_ 4. -FE, '. 2015 p - Ply,ntnn Quality Tested 3" QCEILS'• �nbn..a:oi,e*r Beal polye(yalalline p,w��e.u..u..�o acxo-ai us 113.40032587 "'metlubibi°° APT test conditions: Cells at -1000V against grounded, with conductive metal foil covered module surface, 25°C, 168h 2 See data sheet on rear for further information. Format 1670mm x 1000mm x 32mm (including frame) Is Weight 18.8 kg aasmm i s.r mmme roln<ea.s mA ° Front Cover 3.2 mm thermally pre -stressed glass with 1 i anti -reflection technology a om l<s l rom• -Back Cover Composite film sslee Frame Anodised aluminium Cell 6 x 10 polycrystalline solar cells __ _ _ _ wdb b•. «. n.< Junction Box 110mm x 115mm x 23mm Protection class IP67, with bypass diodes Cable 4mm' Solar cable; (+) a 1000mm, (-) a 1000mm o.rwmmw • merM¢M Connector Tyco Solarlok PV4, IP68 Rnuu ¢a.s mm j � les mm I PDVi!ER,G[ASS a ,.,255m 260 265' MINIMUM PERFORMANCE AT STANDARD TESTING CONDITIONS, STC' (POWER TOLERANCE +5W /- OW) Power at MPP'-PMPP IW1 ��- 255 260 265 Short Circuit Current' Iso [A]- 9.07 9.15 9.23 oc open a V [Vl-° 37.5437,77 38.01 E ( Current at MPP'_'_"__ IMPP [A]- 8.45 8.53 _ 8.62 Voltage at MPP"' VMPP IV] 30.18 30.46 Efficiency' ri [%]� 15.3 15.6 x15.9 MINIMUM PERFORMANCE AT NORMING OPERATING CONDITIONS NOC' Power at MPPP PM" [W1 188.3 192.0 195.7 e Short Circuit Current' Iso [A] 7.31 7,38 7.44 .... e Open Circuit Voltage* Voo [V] 34.95 35,16 35.38 Current at MPP` IMPP [A]6.61-� 6,68 6.75 Voltage at MPP' VMPP IV] 28.48 28,75 29.01 '1000 W/mx, 25 °C, spectrum AM 1.5G ¢ Measurement tolerances STC x3 %; NOC x5 % '800 W/m¢, NOCT, spectrum AM 1.5G *typical values, actual values may differ OGELLSPP RMANCEWARRANTY PERFORMANCEATLOW IRRADIANCE' .,..a_..�. .._.._.a_ r..,., _ o• m At least 97 /, of nominal power during y� • vy.m.mml„I<....,.m.� first year. Thereafter max. 0.6 / degra- � '. __I___I_ _ _- __ ------------------- - a W g dation per year. n At least 92 % of nominalp ower after � •s I , I I I I I I i 10 years. ,.------------------I I I I I I I At least 83 % of nominal power after m.h -• °, '' _____ 25 years. o a All data within measurement tolerances. BOloo ,00 000 to s soo voo soo e°o 1°00 Full warranties In accordance with the warranty terms of the Q CELLS sales IRRADIANCE IwAr'l 71 organisation of your respective country. .uu•.n�. m.. �,.•r-000<i<•.I�.•wl<me<. �01•I rEARs The typical change in module efficiency at an irradiance of 200 W/m� in relation to 1000 W/m° (both at 25 °C and AM 1.5G spectrum) is -2 % (relative). �- TEMEI]ATUF{EGOEFFICIENS Temperature Coefficient of Iso a [%/K1 +0.04 Temperature Coefficient of Vo° P [%/K1 -0.30 Temperature Coefficient of PMP' _ Y [%/K] -0.41 Normal Operating Cell Temperature NOCT [°C] 45 VDE Quality Tested, IEC 61215 (Ed.2); IEC 61730 (Ed.1), Application class A This data sheet complies with DIN EN 50380. AVE ` E NOTE: Installation instructions must be followed. See the installation and operating manual or contact our technical service department for further information on approved installation and use of this product. Hanwha G CELLS GmbH Son nenallee 17-21, 06766 Bitterfeld-Wolfen, Germany I TEL +49 (0)3494 66 99-23444 1 FAX +49 (0)3494 66 99-23000 1 EMAIL sales®q-cells.com I WEB www.q-cells.com Engineered in Germany CELLS Z 0 Fn 5; LU w ui W C, Z < w 00 -j -j E 0 0 wm LLI 0 Q2 co 0 z V 3NliSVO Lu\ w0 0 -C E 0 0 z 0 - - � 0 c > a 2 p Ul 0 m 4t' z zF 9F v4—.,-6 0 .2 t o w ow ¢za,C,uyynz- .0 0 E8— 6 Fu 0, Z' .aL 0 �99 "X C�x t2 z M l M 7. C, �7 — z I-E W'Z > u u50:J Y, zo a, Ow zzq=oof u wrxsxz > 0 W p 'LOO,xu < : 11 z CR a <WQ 7z .-E Sm c5 T C., �7 .1 qFy U6, C -)o Z C, 2, '5 a O >u HOEE"-,zm�ti>-9 z u 0 0 X� 1 t cop W C, Z < w 00 -j -j E 0 0 wm LLI 0 Q2 co 0 V 3NliSVO Lu\ w0 0 -C E 0 0 z 0 - - � 0 c > a 2 p Ul 0 m 4t' z zF 9F v4—.,-6 0 .2 t o w ow ¢za,C,uyynz- .0 0 E8— 6 Fu 0, Z' .aL 0 �99 "X C�x t2 z M l M 7. 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A PH a q H :5 "d ? 7 oz W 0 W0 o z uk U) CL U- 14 CCb Uma >O ma I;c.- z Z0 I va w L z 0 w �,o (D z c, " N 0. x z z >- LL I u ) 8 Z a Lu G �oz Hz sil 2 :E a�t0�� I c,Z z 0 w WO (D z c, " N 0. x z z >- LL I u ) 8 Z a D> G �oz Hz sil 2 :E a�t0�� I c,Z U) AA A sil 2 HN LU Z Z ix cr Ull 4 \A CUPERTINO WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 FILE �� kL1cf- (408) 777-322 - FAX (408) 777-3333 - buildinnOlcuoertino.org S Owner Name i,J _ H 1 0 /yE Permit No Address 0 5 S f' CA S -T 1 � J .T- R V ( 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ) 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? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. ® No Go to Question 3. 3. Is water service permanently 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. '% 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. Skip the rest of the form and sign bottom of form. Yes My real 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 bottom of form.. 5. Please check ONE of the following: 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. 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, as the owner or owner's agent 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 fixtures comply with the requirements as indicated in the table on the following page. r Owner or Owner Agent's Signature: i '�'C -e Date: rf 'i� I 15 Upuu wmpicung anu signing trus t✓enincate, please return it to the building Division in order to tinal your building permit. SB407 2015.doc revised 08/26/15 CUPERTINO 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 • building(a.cupertino.org FILE / Permit No. �// b �S•U Address 1 NE AV e # of Alarms Smoke: i•a, Carbon Monoxide: PERMIT CANNOT BE FINALF,D AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN 6IGhED AND IIETURNED TO THE BUILDING DIVISION 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 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. I have read and agree to comply with the terms and conditions of this statement I ) A Ow w (or Eger Agent's) Name. ------------ 1 /� ✓�� Signature ..............^••:•••'••""••••"..................................................... Date: Contractor Name: Signature...................................................................Lic.4...................................... Date:..................... Smoke and CO form.doc revised 03/18/14