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B-2016-2048 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS; CONTRACTOR: PERMIT NO:B-2016-2048 7738 OAK MEADOW CT CUPERTINO,CA 95014-5201(366 26 010) HOMEOWNER/BUILD ER OWNER'S NAME: RAJPAL VARUN AND SOHINI DATE ISSUED:05/31/2016 OWNER'S PHONE:408-707-8405 PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic.# Contractor HOMEOWNER/BUILDER Date X BLDG —ELECT —PLUMB X 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: REPLACE(E)FURNACE(SAME LOCATION)AND INSTALL(N)AC I hereby affirm under penalty of perjury one of the following two declarations: UNIT-GARAGE 1. 1 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 performance of the work for which this permit is issued. z. 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 permit is issued. Sq.Ft Floor Area: Valuation:$4500.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 366 26 010 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,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the;applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date15/3 /2016 Issued by:Abby Ae� nde Date:05/31/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is L I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(8ec.7044,Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code), Date: /31/201 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the ee is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous G certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the -° air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,S tions 5505,25531,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Ow'er or authorized agent: APPLICANT CERTIFICATION /;Date:5/31/2016 I certify that I have read this application and state that the above information is V CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes, (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. G S g ature Date Licensed 31 2 1 professional GENERAL PERMIT APPLICATIONM E 10 COWiMUNITY DEVELOPMiENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE- CUPER I INO, CA 950143255 LUPI=RT(NU (408)777-3228 • FAX(408)777-3333•_buildino(d)cuDertino.ora1SC apt ❑PLUABING//y� �} 9��(®h CIiANICAL ❑ELECTRICAL ❑husaLLAI�EOUS PROJECT.ADDRESS �/ �� CMZ C�a�� 11 .4PN O}N'NERNAA4EPHO1\�` �t g n 'Ofv tv J Jp ��� E-n�LAIL(; STREETADDPESS �]'� ��A J `� p CITY,ST.4TE�ZIP CONTACT\aN_; �� j I�IAL — PHONE j� ,P1 R ) E•A 4ILJVL /QA � (J ST TADDP.ESS — CITY,STATE, P �r FAX /-A q0I owxmR TJ U I.M,BUIIAEt ❑ OWNERAGENIT ❑ C0\-TPACTOR ❑CO\TRACTORAG>_T"T ❑ ARCHITECT ❑TGL\`EER ❑ DE\.LOPFR ❑ TEI�AI\T CO\TRACTOP.T.4A E �j 6„ Z I LICENS LIC 5 � T BL'S.LIC C 01,11PANTYNA14 1� 1 t�ft7 AJC r/ 6-,- . f t/1 CCK FAX L+ f sSTREE ACI�71PES ( 7 4X q J k UT V n4r1 V A—L- , ��. J I L L o CJ,�'Y,S7_-.TE: '? =l�f'3,I I P Q �`" '[-�.�[ .RCHITECTlENGINEERNA.rSE LICENSE NUMBER V BUS.LIC COMP.,YN"AME E-IIAIL FAX STREET ADDRESS I CITY,STATE,ZIP PHONE USE OF 2,5FD.,D1---PLEX ❑ I TULTI-r'ANiIL.Y PROJECT L\A'ILDLAI.7 ❑ 1-ES PROJECT A ❑1--Es Is THE BLDG AN ❑ YES BUIDP.G: ❑COADMICI-AL I URBAJNINTERFACEAREA NO FLOOD ZONE NO EICHLERHOME? DESCP.IPTI ON OF WORK NEW - , AC r G k A-6—E TOTAL VALUATION: �ECFIVED BI � By my signature below;I ceraf}to each of the follo-, i= I am the property owner or authorized agent to act on the property ov,`�Ier's b=h if I have 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 buildv-rs construction. I authorize representatives of Cupe;tino to enter the above-id tifiledd property for inspection purposes. Sigmature of,Applicant�A, nt: Date: � �3�f r , SUPPLEI\1ENTAL I'\FORMATION REQUIRED - OFfI�E asE'onl.'< .._OPER THELtbw*R,,:hr....;,...:, zR © ST�RD r"k rNO � < ❑ 7�:RGE - 1 r h2A70R� S IEP:.A?isc -pp_:)011.doeregWised 06,21/11 Furnace & a/c at 7738 Oak Meadow Ct, Cupertino C; !\X!' NI d -E ELOPMENT 7, AiENT Vt BU A P P R OV E D _.. flieis set plans a , speca ica sons MU61 ept 5t c ie a site tar9ng ,-trsction. It is unlawful to make any Garage Entry .ang s or alterations on same, or to deviate erefro i, without approval from the Building Official. Sta pine of this pian and specifications SHALL NOT ss ' ;e held to ermit or to be an approvals of the violation. t any rovisions of any City Ordinance or State Law. y ATE` Garage ERMIT.#: m Fence PLOT PLAN JkE KED BY ATE �h b PLANNING DEP ©o o CUPERTINO 3'8- UPS m "' UIiC11P1 epar �j COO Mlbl�C 1D: 4, ;> MAY 3 12016 REI/IEt/VEO �O g, oj3y., �� - . 01 t%I C Ur-UALI UMNIA ALTERATIONS - HVAC CEC-CFIR-ALT-03-E Revised 06/14 CALIFORNIAENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-ALT-03-E Alterations HVAC CZ 1,3 to 7 and 16(formerly CF-IR-ALT-HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: �"7vS o kA4Ic-k1�D10 &T CD PEW T-2 /Vc� Equipment Type Equipment Efficiency New:Ducting,Plenums,Lineset Conditioned Required R-value Floor Area(sq ft) Thermostat Packaged System ,Evaporator Coil n °AFUE COP El R-6 by syst plit System CondensinUnit R-6 (CZ 1,3-7)Ducts Serve Setback g SEER_ El R-8'R-8' (CZ 16) 9 2 (if not already � HSPF El R-6(all CZsq ft's)Plenums present,must Kx,Surnace >@ Lineset EER R-5 o R7: neset3 be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At-pe riait applicatiomthis fiormis=allowed=Abe-filledrout-by-han-.I For final inspection all forms are to be registered(no hand filled forms allowed)and a_copy left on site. 01,HVAC GFiangeout/Repair Required Compliance Documents to be left on site for Final: Can-include new ducting All Equipment, CFIR-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF3R:MECH-20-HERS Installer Requirement:Duct leakage(<15%or,:10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if: ❑1.Duct ystem registered with HERS provider as previously sealed,or 112.There is less than 40 linear feet of duct in LLnronditioned ,space,or .Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building ❑2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF1R-ALT-02-E CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS CF3R-MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS' Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow_350 CFM/ton(or Standards Table 150.0-C/D alternative) ❑3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CFIR-ALT-02-E Ducts'and one or more of the following: CF211WECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS Installer Requirements Duct leakage<6%,Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative) ❑Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. ❑4.-New-Ducting over 40 feet Required Compliance Documents to be left on site for Final: E LT-02- Adding or replacing ducts in unconditioned CF2R:CFIR-ALT-02-MECH- 0 HERS space but less than All New Ducts' CF3R:MECH-20-HERS Installer Required to:Duct leakage(:S-15%or,:L10%10%to outside,or seal all accessible leaks) 15 Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. 'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc. 7A New Duct system is when the duct system is constructed of at least 75 percent new duct material,and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,plenums,duct material 'R-5(I"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter with insulation as the following 1.5-2T-2%",2.5-3T-2W',3.5 to 4T-2%'',5T-4%" Contractor(Documentation Author's/Responsible Designer's Declaration Statement) I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations(CCR). 4. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or system'design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the CCR. 5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit pplication. Responsible Designer Name:' Resp o, igner nature: Date Signed: License: zS Company: ddress: ,;City tate/Zip: Phone: S% 20 For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300 h OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(akupertino.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 - APN BP# A �� �r OWNER NAME OWNER ADDRESSC)Ar �� DESCRIPTION OF WORK: 1 — 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.) 1. 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. A,2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the',c nstruction and are not hiring a licensed Contractor to assume this responsibility. I 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. I understand Contractors are required by law to be licensed and bonded in California and to list their license num ers on permits and contracts. 4 ' 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 me!tof serious financial risk. A71. I 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 Xfiserormed under contract with a Licensed general building Contractor. I 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. OwneTBuildeYFonn 2010.doc revised 04/14/10 a u. I understand I may obtain more information regarding my obligations as an "employer"from the Internal evenue 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. Lf--L-10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I m,th ae party legally and financially responsible for proposed construction activity at the site address listed above. � -- 11. I agree that,as the party legally and financially responsible for this proposed construction activity, I will abide by alll applicable laws and requirements that govern Owner-Builders as well as employers. t a2. 1 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 by laws 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 financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is 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 you obtain a permit as Owner-Builder and wish to hire Contractors,you will be responsible for verifying whether or not 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.) 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: j` 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 driver's 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, Signature: r Date: 0 6 ------------ -------------------------- ------------------------------------------------------------------------------------- --------------- (NOTE. The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). IY 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: Tel No Address of Authorized Agent: 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 owner's driver's 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: Date: Owne7BuilderForm 2010.doc revised 04/14/10 i i SMOKE / CARBON MONOXIDE ALARMS lS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINt? 10300 TORRE AVENUE CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333 building(a)cupertino.org Permit No, o2v 1 -6 L ` Address `� l f)mo G7, #of Alarms Smoke: i I . arbon Mc noxide: PERIVIIT CANNO BE FINALED ANI)COIVIP�ETED uNTZI,Txls cERTIFIGA u �yl izr s, C3DI"VS ON T �SUIVB y PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxid 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 SmokeAlarms and Carbon I Monoxide alarms. When the valuation of additions, alterations,or repairs to existing dwelling u 'ts 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 C O ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On ever level of a dwelling unit including basements X X y � Wi.thm each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning applia aces and.that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall co reply 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,baservent 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 h /have been installed in accordance with the manufacturer's instructions and in compliance with the CaliforniaBuilding and California Residential Codes.The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to comply with the ter s and conditions of this statement Owner(or Owner Agen's)Name: Signature.......................... .......: ......... ................................... Dateo ...�.. Contractor Name: Signature .. .. .. .... .. .. .. :.I ��.� l...7.......: Date. dp�'... Smoke and COform.dj revised 03118114 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 0 TORRE AVENUE-CUPERTINO,CA 95014-3255 1030 N (408 777-3228•FAX(408)777-3333•building(u)cupertinYermit No;. Owner Name j / �� b Address -7? 30e IDAP( t "V,4P atxf C c 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 cf form. l 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 r 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. Q 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 f 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 f 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 a d sign bottom of form.. 5. Please check ONE of the following: Ifi 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 plumb' g 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 unprovements 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 r 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 improve ents). 1,as the owner or owner's agent of this property,certify underpenalty of erJm'Y that non-com liant 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 Incicatein the table on the following page. Owner or Owner Agent's Signature: Date: 0 t Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB4072015.c,oe revised 08126115 I