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15110057 SMOKE/WATER F L SHONE / CAN � ALARMS - s � �1 , OWNER CERTIFICATE OF COMPUANGE COMMUNITY DEVELOPMENT DEPARTMENT=BUILDING DIVISION � 1710300 TORRE AVENUE>CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buiidina(d)cupertino.org Address �13�-1 ��k '��i �ie� ��Y-IARL 4 of AIarWs S rok6: Carlon Monoxide PERMIT CkNNOT BE FINALED AND COMPLETED UNTIL IUS CERTIF'ICATIE HAS BEEN 51 N, ANT RE, M-L,D_-TO THE BUII,13LG DI vISI(}N - PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for __`compliance with 2013 CRC Section 8314 2013 CBC Sections 420.6 and 907.2.11.2 where no interio-access for_,___: _ _.r F_ ,. 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 in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping'area in the immediate vicinity of`the X X bedroon-i(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:Iu dwelling units with no commercial power supply,alarm(s)may be solely battery operated. —_ irti ex s`tm dwellimigrnl ts,alarrnyarepermaTted-to be sotely-battery operaie-� rere�-repai rs'or arteratiTits-do--p"- - riot 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 R3-14 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 owl-ter 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 aiLd 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 r7P 'd�€owner ArertrS)Name;, ). v Si natu e.. Dare: C.�ria for Name; _ " . (' /V� 4.J/ Si nafure................ ................. ...L�c.#........ te: ..� 9 Srno'e and CO forn7.doc re=iced 03118114 1 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICAT E OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 103Q0 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228 FAX(408)777-3333•building c)-cupertino.org j' Owner Marne '�` �-(-�S l i 1 t D Per nit No. Address 2A 121A aiNrg= �j iN\Q 0 i 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. 9' 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. -Q r~ne A e"nsed ptzcp 3'Oerls e3`i�a dtioii-h ie�r1 71'ovldeir tfrirYe Suitt b iFlBifau.-- Skip the rest of the form and sign bottom of form. ',No Go to Question 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. J9 No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 0 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.. X 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 7rzu41tifainily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant piu}m'aisng fix ores to be replaced Nvith On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water conserving plurmbing fixtures throughout the building(regardless of whether property undergoes alterations or iinprovo ments). Ell My property is a c0777r7ercial real property. See Civil Code Section 1101.5. On and after January 1, 2014,specified building alterations or improvements shall require non-compliant plumbing futures to be replaced with water-conserving plumbirig 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 manufacturers installation requirements, and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following age. e' i' Owner or Owner Agent's Signature: 22LJ�� Dat Upon completing and srgr its-t'nistCertifrcate,please return it to the Building Division in order to final your bulding per�rtt '+ r SB, 7 2015.doc i evised O8f2 ll