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B-2016-1455CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1455 23500 CRISTO REY DR UNIT 116B CUPERTINO, CA 95014-6521 (342 54 999) ( BAY AREA ENTERPRISE SAN JOSE, C� 95148 OWNER'S NAME: CAROTHERS W DOUGLAS JR TRUSTEE & ET AL DATE ISSUED: 03/07/2016 OWNER'S PHONE: DOUG CAROTHERS PHONE NO: 408-238-5043 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #817817 Contractor ( BAY AREA ENTERPRISE ) Date 03/7/2016 X BLDG X�LECT _PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: UNIT 116B - REMODEL 2 (E) BATHROOMS (92 S.F.), ADD 45 (N) under penalty of perjury one of the following two declarations: RECESSED IGHTS, 10 (N) SWITCHES, 5 (N) OUTLETS, AND 4 (N) ve and will maintain a certificate of consent to self -insure for Worker's CIRCUITS. STALL (N) SOFFIT IN BEDROOM ONE. mpensation, as provided for by Section 3700 of the Labor Code, for the Vm formance of the work for which this permit is issued. ve 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 Sq. Ft Floor A ea: Valuation: $27590.00 this permit is issued. APPLICANT CERTIFICATION I certify that I have read this applicationand to that the above APN Number: Occupancy Type: information is correct. I agree to comply wit I city and county 34�-5`99�"�,5� �� ordinances and state laws relating to buildi construction, and hereby authorize representatives of this city to ent upon the above mentioned property for inspection purposes. (We) ag a to save indemnify and keep harmless the City of Cupertino against liabi ities, judgments, costs, and PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said C ty in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additi Wally, the ap licant understands and will comply with all non -point sou a regulation per the Cupertino Municipal 180 DA S FROM LAST CALLED INSPECTION. Code, Section 9.18. /�_/ .d� Issued by: ALEX VALLELUNGA 00g&ture Date 03/7/2016 Date: 03/7/2 16 OWNER -B IL LARATI RE -ROOFS: I hereby affi that I am exempt from the Co ractor's License Law for one of the All roofs shal 1 be inspected prior to any roofing material being installed. If a roof is following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for m. I, as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: 2. I, as owner of the property, am exclusively contracting with licensed Date: 03/7/2016 contractors to construct the project (Sec.7044, Business &Professions Code). AL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: 1. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under hapter 6.95 of the 2. 1 have and will maintain Worker's Compensation Insurance, as provided for California Health & Safety Code, Sections 25505, 2553 , and 25534. I will by Section 3700 of the Labor Code, for the performance of the work for which maintain co pliance with the Cupertino Municipal Code Chapter 9.12 and the this permit is issued. Health & afety Code, Section 25532(a) sh uld I store r handle hazardous 3. I certify that in the performance of the work for which this permit is issued, I material. Ad itionally, should I use equipm t or device which emit hazardous shallair not employ any person in any manner so as to become subject to the contamin will maintain nts as defined by the Bay Area it Quality anagement District I compliance with the Cupertin unicipal ode, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health & Safety Code, S cti s 5505, 255 3, and 25534. 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 d ;her or authorized agent' be deemed revoked. I fate:03/7/2016 APPLICANT CERTIFICATION N TR CTIONL ING A E Y I certify that I have read this application and state that the above information is I hereby affirm of work's for which that there is a construction I ding age cy for the performance this is issued (Sec.7, C- C.) correct. I agree to comply with all city and county ordinances and state laws permit relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Adc cess judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant ARCHITECT'S DECLARATION understands and will comply with all non -point source regulations per the I understand rny plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Professional Signature Date 03/7/2016 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' (408) 777-3228 e FAX (408) 777-3333 • building(a)-cupertino.org CUPERTIN ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERNHT # 7Z 6\Q ' qt PROJECT ADDRESS 1 f f - APN# --?#z V OWNER NAME ` 7 PHONE _ C� ' r� F,�Q� Q �� nO�`c s a ( , STREET ADDRES C'Y, STATE, ZIP L9 �,, ,,1 NJ FAX ® �El-MAL CONTACT NAME PHONE �©� —t-el5 STREET ADDRESS � CITY, STTATE, ZIP �] ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 11CONTRACTOR AGENT 11ARCHITECT ❑ ENGINEER 11 DEVELOPER ❑TENANT CONTRACTOR NAME el ` LICENSE NUMBER 7TLICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL _ �e(� FAX BSLAl,� y v • ray � STREET ADDRESS ` Z Il CITY, STATE, ZIP , z'+' PHONE --- z -v c� G ti v► ��-T � ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL _ --�-�_ FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Q —Ate II L6 b � sS ��P It < �'�`S �I ! SW;� s Its - etj moi- C+ -G;= rl eft .� L'i� t�a'ci,I� '� L`Ctliil� Fi �� volts t s � 1'��5 g /t/�1•✓ �TL �iL�`i �� 6��10 5 k i � �'t -" ` Y W tk EXISTING USE USE STRTYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION ($) J7 EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH ARE GARAGE AREA: ❑ DETACH ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNrT []YES SECOND STORY []YES BEING ADDED? ❑ NO ADDITION" : []NO PRE -APPLICATION , ❑ YES IF YES, PROVIDE COPY OF IS THE B AN ❑ YES RECEIVED BY.' TOTAL VALUATION: �® PLANNING APPL # []NO PLANNING APPROVAL LETTE EICHLEME? []NO p fi By my signature below, I certify to each of the mt a property owner or authorized agent to act on the property s beh I h e read this �ing:l application and the information I have provid is rav read the Description of Work and verify it is accurate. I agree to mply with all applicable local ordinances and state laws relating to buil in ons chorize representatives of Cupertino to enter the above -identified pr �rtyor i pection purposes. Signature of Applicant/Agent: Date: / SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ "BUII DING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS E PiANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ : Pukic woRKs form if any Hazardous Materials are being used as part of this project. ❑ °:LARGE El: FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ .MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ . ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06121111 m /V V_ Rwc 1 CITY OF CUPERTINO W-M-N7 FFF ESTIMATOR—'RIALDING DIVISION im,ADDRESS: 23500 CRISTO REY DR DATE: 03/01/2016 REVIEWED BY: ALEX APN: 342-53-011 BP#: *VALUATION: 1$27,590 ^PERMIT TYPE: Building Permit ' ath (<=300 sf) 1 MRESBAT PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi -Family Dwelling USE: PME Plan Check: Buildina is >3 Stories 0 Yes (j) No PENTAMATION 1 R2REM PERMIT TYPE: A WORK UNIT 116B -REMODEL 2 E BATHROOMS 92 S.F. , ADD 45 N RECESSED LIGHTS, 10 N SCOPE SWITCHES, 5 (N) OUTLETS, AND 4 (N) CIRCUITS. INSTALL (N) SOFFIT IN BEDROOM ONE. NOTE. This estinzate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitazy Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. contact the Dept_tor aaan't info. FEE ITEMS (Fee Resolution I1-053 E . 7111131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 $0.00('$645.00 92 s. f. ' ath (<=300 sf) 1 MRESBAT Suppl. PC Fee: ) Reg. 0 OT 1 0.0 1 hr's PME Plan Check: $0.00 $0.0 45 $222.00 ^e7a W 1BREMFIXT Fixtures, Lighting Permit Fee: Suppl. Insp. Fee -.0 Reg. Q OT Rol hrs $0.00 1 Electrical $48.00 1B 11IRECEP Recep/Switch/Outlets PME Unit Fee: PME Permit Fee: 48 4 # Electrical ("On'stf°uction Tax: 572.00 IB EMMISC I Special Circuits Administrative Fee: JADAffA z 1' Work Without Permit? 0 Yes Q No Advanced Planning Fee: $0.00 $48.00 Select a Non -Residential Building or Structure G 0 Travel Documentation Fee: ITRA VD0C Strong Motion Fee: 1BSEISMICR 3.59 Select an Administrative Item —p Bldg Stds Commission Fee: IBCBSC $146.591$1,487.00 Revised: 01/01/2016 BAE - Master bath porcelain tile for Mortar installation Guest Bath will be travertine with matching base 1/4 round ordered Shower pan and floor will be Porcelain or travertine with base SHOWER Curb finish flush with the bele boards in remainder of beth Center drain in shower pan space Granite countertop over toilet BAE NOTE: BLOCK FOR BENCH SUPPORT Bench frame installed BENCH -BUILD 2 x 4 Seat including pony well Build wall to well support shelf In 5/8 ply Tiled finish appmx. 323/4"W x15"D x,9"H AFF Finishedtop l l/2"H(from)x45" Xb"D Change in Kitchen under lighting Better to be well to wan . open urger bench Granite top finish approx.21"HAFFx75"D CentTop of granite shelf 37 112" AFF Shaer head land valve prim Shower head end valve LeR well Centered cabinet 9 9 9 Change in Kitchen bridge lighting 9 9 9 9 CENTER TOILET IN SPACE BLOCK for Grab bar right of toilet g BLOCK for L sham ba et at certa b511�emchi (RI wale BLOCK for L shape grab bar M comer of bench/shouter valve 5hgwer A-@ T8"N AFF Shower valve center ® 45"H AFF / 5HOWER VALVE CENTER ON WALL AT 45"H AFF Remove mad rob - 5heetrock niche ,�� 32 3/4' Finish u4th paint and glass shelves \ /// Hand held bar (24') - center on valve top at 80"AFF EL Glace 51'H AFF g 10" left valve center / Build 7 -iced Niche - 1474 x 14 H 29" 14 Bottom Approx54"H AFF Center on bench wall if needed Bench I Bence 24"W grab bar — — — — — — E2 O center on back wall � E4 o 0 ° 12� E2 - --1 HOOK b3" El �I 12"N -.--„�wer door (— — — — — I SAVE Paint nt color R I�rae Colum Save existlng soffit r �tj t 5 I L BAE -REVISED Soffit depth needed towards kitchen Incorporate existing - 53" x 5 1/4" x 25" D PROVIDE 50LID WOOD BLOCKING INSIDE 5OFFT !! i BUILD Soffit incorporating existing beam 53"W X 5 1/4H x 25"D for Bridge cabinets and crown to mount ALU N----� r I 5 ve - dsbng sod flooring " Save Existlng soffits New crown end baseboard q\ Paint .I SII Living room - Hardwood flooring _ IARTMENT I - New doors, casing, handles throughout apartment E DEP meter crown and base _ New Peri COMMUNITY DEVELOPMl_ C Paint BUILDING UIVISIGN UPERTWO !<;I_ ' " ; Master bedroom - Hardwood Existing t� I PPt at th I Match ht. of NEW soffit to perimeter In home AF PMUST be t''�+ l Make soffits 10" W entire perimeter ecif ications ,,, New crown detail with tape light, new casings and new set of plans and specifications I PeseboeM It is unlawful ' Paint s;te during construction. or tc �s or alterations on same, a_ chang� royal from the Building Uri``" \ Ao .',,;erefrom, without app , , I . {cati�. E The stamping of this p!'n nn_ oval G. • ,J r Itheld to per I �rleions of ^,n OFFICE 00MQ � p LPN e- C'0 TE , Z6/,6- it p o� HERMIT NO. �. MASTER SUITE �e DRAWINGS PROVIDED BY: PROJECT ESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE SCALE: DATE: KDC Kitchen arot�ers and Bath Gallery 3500 Cristo Ray Dr. #116B Floor plan 1/4"=1' 2/19/16 K-1 Cupertino, CA 95104 BAE NOTE: BAE NOTE: Need junction in master for Lighted vanity mirror Change in Kitchen under cabinet lighting 5EE revised elevation (pg.K-6) for placement Change in Kitchen bridge lighting Remove coed cab - 5heetma niche HDMI 8 AFC.I FH MASTER SUITE DRAWINGS PROVIDED BY: PROJECT ESCRIPTION: SHEET TITLE: KDC Kitchen Carothers Electrical and Bath Gallery 3500 Cristo Ray Dr. #116 Cupertino, CA 95104 11 1 desk GvP gePa� 6 p� �pR GoMP Ev F0?, C, Ei�J\�`N J�e�ed 6y �e DATE 2/19/16 K-2 Balfour in paint maple Buttermilk Montage M-0004 Use Statesman drawer face on top drawers No upper glass doors on this side CREATE BEAUTIFUL shapec ALL cabinets on this wall have 4 1/2" reveal 5EE 5PEC ADD riser #BA44 attached to 3/4" filler (1 1 / Grown #1615 to ceiling E5 -3L � Under cabinet - PL 3/4 x 15 x 46 with Attached #618 trim Apply to base of 2 cabinet, flush with face of doors Trim on side of cabinet will extend approx. 1/8" (hide seam) Install (2) Med. Madeline Corbels -21N x 6H x 6 1 /80 Flush out side and 1/4 " from box edge inside E5 3-L 5 Scribe B BASE - NOTE 5HEETROCK Y-IALL (right side of REF) MU5T BE PLUMB ! REF Column flush to wall i "a' vii oiuc. " ""' ice, "" "', ", aNNi vn. uv V nuG aca.n/ Install (2) Med. Madeline Corbels as shown -2 x 8 x 6 1/8 Flush outside & 1/4" from box edge inside Elevation 1 panels -1/161, ERTINO I Department 6 OMPLIANCE BAE - REVI5ED 5offit depth needed BAE NOTE: r 53"W x 5 1/4"H x 25" D Revised electrical interior box and bottom of box PROVIDE 50LID WOOD BLOCKING IN51DE 5OFFT !! Bridge cabinets one piece - b4"W x 15 1/2"H x 13"D E5 - scribe to wall Prep for clear glass doors MOUNT Bridge Center of soffit Face of cabinet box vertically to match sink side of sheetrock pony wall E5-1 1/2" L 21" 21" 21" M5C 101114 - Crown 1" H x 1 1/2"D Both sides of bridge V. v E5-11/., R7FTF] cy U) 11 BEPF3x341/2x2' Trim to fit for DW spg CENTER Under cabinet support on bridge MWT 84" kN x 1 1/2"H x 16"D Factory added molding will finish 16" CENTER CORBELS ON UNDER CABINET SUPPORT DW Integrated panel 5EE CAB SPEC 25 5/8" x 30" ce a 0 0 o 0 11/2"24" 311/2" 25" 1, BF -1" 83" Sink Base 31 1/2" x 2b"D with 2 -English estate bun foot 5025-04 standard 24"D pulled to 25" deep to bypass waste line Elite drawer head all top drawers NOTE: Body Glove Full Flo Water filter system at kitchen sink (BG -6000) v 0 CUPERTINO Ruilding Department LIAR 01 2016 REVIEWED FOR CODE COMPLIANCE Revlewed BY 6 4A�--- DRAWINGS PROVIDED BY: PROJECT ESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE SCALE: DATE: KDC Kitchen Carothers and Bath Gallery 3500 Cristo Ray Dr. #116 1/2"=1' 2/19/16 K- 4 upertino, CA 95104 BUILD Soffit incorporating existing beam Revised depth 83"W X 5 1/4H x 25"D for Bridge cabinets Cabinet will be centered on soffit depth BAE - PROVIDE SOLID MOOD BLOCKING IN510E 50FFIT Family room side of kitchen Bridge cabinets prep for clear glass 54"Y4 x 15 1/2"H x 13"D E5 -scribe to wall CUPERTINO wilding Department MAR 0 7 2016 REVIEWED FOR CODE COMPLIANCE Reviewed By. -- DRAWINGS PROVIDED BY: PROJECT ESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE SCALE: DATE: KDC Kitchen Carothers 3500 Cristo Ray Dr. #116 Kitchen Bridge K— 5 and Bath Gallery, 1/2"=1' 2/19/16 Cupertino, CA 95104 E53 -L Scribe to wall MED. Cabinet CENTER on vanity side wall With electric outlet Vanity box will have 45 degree angle for this wall o. 00 EgliF1,r v 637/51, Revised vanity Revised sink location E55 -R Scribe to wall Guest bath vanity - in cherry wood with French toast stain Luxemberg full overlay door style with 5 piece drawer head left Off -set sink bowl Center mirror and fixture on wall Guest Bath m i to shelf top 311/2" AFF ,III�II 11,11g11,1111. BAE: ADDITIONAL ELECTRICAL Make up Mirror Hardwired in Master bath i BOT Roll-out Master Bath CUPERTINO �uildinq Departnenx f MAR 0 7 2016 REVIEWED FOR CODE COMPLIANCE Reviewed By. r 32 3/4" 21 5/8' 45 3/4" 13314- 14a• 63 •,4- 1 _ 139 'o CUPERTINO -�uildinq Department MAR 0 7 2016 t�EVIEWED FOR CODE COMPLIANCE 44 3/4' Keviewed By. �- - DRAWINGS PROVIDED BY: PRO]ECT QESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE SCALE: DATE: KDC Kitchen Carothers 7 and Bath Gallery 3500 Cristo Ray Dr. #116 2/19/16 K- upertino, CA 95104 L �� 1- T S /_:- SMOKE / CARBON MONOXIDE ALARMS - 'Olio OWNER CERTIFICATE OF COMPLIANCE 4S.p, COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CUPERTINO10300 TORRE AVENUE a CUPERTINO, CA 95014-3255 (408)777-3228°FAX(408)777-3333 o building cupertino.orq 'Permit No. — , Address L if') u L1t� U �r +11613. t — '11__ _ #of Alarms Smoke:r Yl Carbon Monoxide::1 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE t HAS BEEN,SIGNED AND RETURNED 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 9072.11.2 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 $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) °�— On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alainns combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply In dwelling units with no commercial power supply, alarm(s)may be solely battery operated. In existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes.The alarms have been tested and are operational,as of the date signed below. I have read and agree to comply with thjt s and conditions of this statement Owner(orwne�s)Name: Date:' .1. Gr'e_e, F�l S Signature. Contractor Name: f �J 1447 gay nn Ft1.`r4tcfre Signa're.. Lic.# l �p 1 Date:: Smoke and COfor.m.doc revised 03/18/14 t I WATER-CONSERVING PLUMBING FIXTURES rip OWNER CERTIFICATE OF COMPLIANCE ,-c.,,,s$ COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION C Pl~I TfNE? 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 e (408)777-3228•FAX(408)777-3333•buildincacupertino.orq Owner Name. i f' r'-'44t•e V 5 Permit No. 7z-ea 1r —)(417-5-7 ' Address 315 C it, 5 h? al A- . 1. Is your real property a registered historical site? 0 les Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0-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. 0 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. lNo Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? Q 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. ler 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: 0 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). tV 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 plumbingfixtures 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 ofrjl 'that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbin_. fixtufes in accordance with Civil Code Sections 1101.1 through 1101.8,the current California Plumbing Code Californi. -efn Building Standards Code,and manufacturer's installation requir 1 ents,and that the water-conserving olumbing r es comply with the requirements as indicated in the table on the foil. g page. Owner or Owner l gent'-Signature: Date:,_ 117/ 'XV Upon compl ting •id signing this Certificate,please re t e-the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15