B-2016-1331 SMOKE/WATER SMOKE I CARBONMONOXIDE ALARMS
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0-ER CERTIFICATE OF CC�IVII DANCE
COMMUNITY DEVELOPMENT DEPARTMENT*BUILDING DIVISION ILE-
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10300 TORRE AVENUE®CUPERTINO,CA 95014-3255 j
(408)777-3228 W FAX(408)777-3333®building(akupertino.org
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PERMIT CANNOT BE FINAIX,�D AND COMPLEXED UNTH,TffIS CTUS-1 EI2TIFYCA7[E
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 u1 the following locations:
AREA SMOKE ALARM COALARM
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 in room X
Carbon Monoxide alarms are not required m dwellings which do not contain fuel-bumiung appliances and that
da 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, alarms)maybe 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 isno 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 mustbe 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 BuildiFng
and C'al form a Residential Codes.The alarms have been tested nid are operational,as.of the dates signedl
below..
tt have+read and a;,reef tb come J withf,the,teams andf conn&dans off this statement
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WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE F1
COMMUNITY DEVELOPMEW DEPARTMENT.BUILDING.DIVISION
CUPERTINO 10300TO;RREAVENUE•C RTNO,'CA'.950'1432
g. (408 777228 t FAX{408 777-33 q,buiidin perUrK).ong
Owner Nam Permit No.6 2016- l .73
Address
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.
525-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.
' � o Go to Question 4.
l
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.
f =i Yes M real roe is built and available for use or occupancy on or before January 1 1994.
Y property rtY� P Y rY ,
Civil Code Sections 1101.1 through.1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. ase check ONE of the following:
P PI 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 realproperty. 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, 20.19, 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 110'1.1
through 1101.9,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.
Owner or OwnerAgenfs Signature. 1 ` Dat
Upon completing and signing this Certificate,please returA it to the Building Division in order to final your building per. '
SB&407 2015.doc revised'08/26/15