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B-2016-1493 SMOKE/WATER m SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION C'U P E:RTt iN Q 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-.3333•building(_Dcupertino.org 'ermt '-2 b d (A-f4 I -�:A_ddras— 23 s✓ l� Un</�5 ? �'v��s{ya m C''—#—Oarms Smoke? Carbon lVlonoxide PERMIT CANNOT BE FINALED AND COMPLETED UN'TIL THIS CERTIFICATE HAS BEEN .AND'RETURNED 1_'THE BI7II,DINI3 ID�VISION 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 )( 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. h-i 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 wl-dch 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 ofXhis statement 9w ofwne(, qc nrs}Nan*-- Si natur ,...... .ate-,r��... ..........................C Date ..... -Contraei';or_Na�e: Sinaf reureu ........ <L r.................... ..............."Date:................... Sinoke and COform.doc revised 03118/14 RVI OWNER ICRATE OF ICOMPLI FILE COMMUNITY, EVEL 1T DEPARTMENT-RU,(LONG DIVISI A �--1 CUPPERTIN 1 i34►JTORf2E.A�lEMtJ Rfit1d0,GA`95014-325:5 fs (408)777-3228•;FA,�40,8)777-3333 build riot i �r'cirio:arca Owner Nam Permit N t 6 cL Address 2 365` �a(c �+�� d L Is your real property a registered historical site? ❑ Yes Civil`Code Sections 110E 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 filcfures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certif cation has been provided to the Building Division. Skip the rest of the form and sign bottom of form. - Ef No Go to Question 3. 3. Is water service pe> riarrently 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. 21 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'.T thrOUgh 1101.8 do not apply. Skip the rest of form and sign bottom of form. Cil"Yes My real property is built and available for use or occupancy on or before January 1, 19914. 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: M properGr is asrrrg�s�a`•Irrcl}�resdemrtleel real ,ro,e :. See Civil Code Section 110'1.4. p p sty. On arid,after January 1, 2014,building alterations or improvements shall require all non-cozVliant plumbing fixtures to be replaeed with water-conserving.plumbrng,fixtures throughout the building.Dir or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumWR'9 fixtures (regardless of whether property undergoes alterations or im.,prOve ments). El Mypropertyis,Xmtmsly residential realproperty See Civil Code Secfiet 11011.5, On and after January 1,2014,specified building,alterations or imptoveimerifa shall re -iu fie non-compliant plumbing futures to,be replaced with wafer—conserving plumbing fixtures. ©r or before January 1, 20-19`, all,non comphanl plumbing fixtures shall be replaced with water- conserving plu2mibing fixtures throu=ghout the big ft(regardless of whether property=t&rgoes alterations or iiriprovei�ients)�. ❑° My property ins.a,,cormm-ercial real property.. See Civil Code Section 1101.5. On,and after,January 1,20?l4,specified buiVing.,ail'teraCioris or improvements Shall regnim non compliant plumbing fixtures;tot be replaced wittik water cons'ervirig pLulnhing fxtures. Oris or before January 1„ 291,9„ all non-compliarit, plumbing fixtures shall be replaced with water- conserving plulnbing fiktures;d' oughnut the:building,(regardlless of whether property undergoes alteiatibris=or impro-vements)�. 1,as the otivner ar owner'si agent of thi's prop.ertY,,certify undies penalty ofperjury that non=compliant pliimbuig fxt res will be replaeedprior to�d-ate speci�i-edd above-,with water conserving:plumbing fixtures in accordance-with,Cuivil Code Sections 1101.1 through 1101.&,,the current Cal ifomiaPlumbing,Code and Calrfomia Green,Building S)tandard's:Code,,and:manufacturer's installation requirements,and that the:water=conserving.plumbing fixtures comply with,the requirements as indicated in the table om the fallowin:. ,a.;e, Owneror.OvanereAg�nti�s S'rgrinture t����,°"- `��� Y U'Pon,completrng and,t.signiiig thin Cerhfieate,,please returns it to thiiRding Division in order=to.final,,yourbuRding.permit. SB407 201'5.A9c revisedG 08126115